Sex-reassignment surgery male-to-female. Review, own results and report of a new technique using the glans penis as a pseudoclitoris.

摘要: Sexually deviant humans have been mentioned since antiquity and presumably existed at all times. Opinions on the subject varied throughout recorded history. Nowadays we distinguish between different forms of sexual abnormality, a.o. transvestites, homosexuals transsexuals. The estimated prevalence transsexualism varies in societies cultures among men 1/100.000 1/2.900. etiology is unknown. There proposed from psychological conditioning childhood or an unusual paranoic state to genetic disturbances. Current investigations indicate that mutations SRY-gene might be a cause. Surgical sex-reassignment male transsexuals began 1930s, but ideal method has not yet found. aim surgical intervention primarily social psychologic rehabilitation patient, as psychiatric therapy invariably fails "cure" true transsexual, i.e. person early absolute unalterable conception himself belonging opposite sex. In 1978-87 author performed 13 transsexual biologic males, using modified technique which urethra glans penis were preserved transposed position introitus neovagina serve "pseudoclitoris". six cases this procedure was successful. advantage over previous operations with its sensitive mucosa saved neovaginal introitus. disadvantages are will necrotize if blood flow through corpus spongiosum strangulated second-step operation required resect trim after it well healed. Complications results similar those earlier case series. Factors important for success include patient age less than 30 years old ability handle vaginal dilator correctly conversion. Orchiectomy should soon diagnosis confirmed, estrogen dosage can reduced.