Perovic S V, Stanojevic D S, Djordjevic M L
Belgrade Gender Dysphoria Team, University of Belgrade, Yugoslavia.
BJU Int. 2000 Nov;86(7):843-50. doi: 10.1046/j.1464-410x.2000.00934.x.
To describe and present the results of a one-stage vaginoplasty in male-to-female sex reassignment surgery.
The present technique is based on penile disassembly and the use of all penile components for vaginoplasty (except the corpora cavernosa). The neovagina consists of two parts; a long vascularized urethral flap and a pedicled island tube skin flap created from the penile skin. The urethral flap is embedded into the skin tube. The tube, consisting of skin and the urethral flap, is inverted, thus forming the neovagina. The new vagina is inserted into the previously prepared perineal cavity between the urethra, bladder and rectum. The neovagina is then fixed to the sacrospinous ligament. The labia minora and majora are formed from remaining penile and scrotal skin. The new method was used in 89 patients (mean age 28 years, range 18-56) with a mean (range) follow-up of 4. 6 (0.25-6) years.
Good cosmetic and functional results were obtained in 77 of the 89 patients (87%). Importantly, the neovagina produced in most patients was of satisfactory depth and width. There was only one major complication, a rectovaginal fistula caused by intraoperative injury to the rectum.
The technique produces a vagina with more normal anatomical and physiological characteristics than those produced by other methods, as all the penile components are used (except for the corpora cavernosa) to form almost normal external female genitalia. Vaginoplasty using pedicled penile skin with a urethral flap is a good alternative to other methods of vaginoplasty in male-to-female sex reassignment surgery.
描述并呈现男性变女性性别重置手术中一期阴道成形术的结果。
目前的技术基于阴茎拆解，并利用阴茎的所有组成部分进行阴道成形术（除海绵体）。新阴道由两部分组成；一个长的带血管蒂尿道瓣和一个由阴茎皮肤形成的带蒂岛状皮管瓣。尿道瓣被嵌入皮管中。由皮肤和尿道瓣组成的皮管被翻转，从而形成新阴道。将新阴道插入先前在尿道、膀胱和直肠之间准备好的会阴腔内。然后将新阴道固定于骶棘韧带。小阴唇和大阴唇由剩余的阴茎和阴囊皮肤形成。该新方法应用于89例患者（平均年龄28岁，范围18 - 56岁），平均（范围）随访4.6（0.25 - 6）年。
89例患者中有77例（87%）获得了良好的美容和功能效果。重要的是，大多数患者所形成的新阴道在深度和宽度方面令人满意。仅发生了1例主要并发症，即术中直肠损伤导致的直肠阴道瘘。
该技术所形成的阴道具有比其他方法更正常的解剖和生理特征，因为利用了阴茎的所有组成部分（除海绵体）来形成几乎正常的女性外生殖器。在男性变女性性别重置手术中，带蒂阴茎皮肤联合尿道瓣的阴道成形术是其他阴道成形术方法的良好替代方案。
