title: Solely Penile Skin for Neovaginal Construction in Sex Reassignment Surgery.
abstract: BACKGROUND
  Gender reassignment surgery due to transsexualism (International Classification of Diseases, Tenth Revision: F64.0) is a procedure becoming increasingly common worldwide as a result of a significant increase in diagnostic incidence. Several methods have been described for this complex surgery, but no internationally agreed upon gold standard exists, in particular with regard to which methods allow for creating a sufficient neovaginal depth.
  
  
  METHODS
  We use a 2-stage technique using solely penile skin for creating a neovaginal cavity and present the long-term outcome in terms of measured neovaginal depth. Eighty patients were included. Patients' neovaginal depth was measured in a standardized fashion 6 months or more after initial surgery. Results were compared with published data on female anatomy.
  
  
  RESULTS
  The average neovaginal depth achieved was 10.2 cm. Having had a postoperative complication and noncompliance to neovaginal dilatation were both negatively correlated with neovaginal depth, whereas higher body mass index was not. Most patients received a neovaginal depth sufficient for penetrative intercourse and within the range for biological women.
  
  
  CONCLUSIONS
  Using solely penile skin for the vaginal lining is a satisfactory surgical method to achieve adequate vaginal depth, provided that the postoperative dilatation regimen is followed. This holds true regardless of age or body mass index.
authors.affiliation: Stockholm Craniofacial Center, Department of Plastic and Reconstructive Surgery, Karolinska University Hospital, Stockholm, Sweden; and Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
authors.forename: Hannes
authors.initials: H
authors.lastname: Sigurjonsson
authors.affiliation: Stockholm Craniofacial Center, Department of Plastic and Reconstructive Surgery, Karolinska University Hospital, Stockholm, Sweden; and Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Rinder
authors.affiliation: Stockholm Craniofacial Center, Department of Plastic and Reconstructive Surgery, Karolinska University Hospital, Stockholm, Sweden; and Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
authors.forename: Ebba K
authors.initials: EK
authors.lastname: Lindqvist
authors.affiliation: Stockholm Craniofacial Center, Department of Plastic and Reconstructive Surgery, Karolinska University Hospital, Stockholm, Sweden; and Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
authors.forename: Filip
authors.initials: F
authors.lastname: Farnebo
authors.affiliation: Stockholm Craniofacial Center, Department of Plastic and Reconstructive Surgery, Karolinska University Hospital, Stockholm, Sweden; and Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
authors.forename: T Kalle
authors.initials: TK
authors.lastname: Lundgren