Imbimbo C, Verze P, Arcaniolo D, Mirone M
Urologia. 2007 Oct-Dec;74(4):187-96. doi: 10.5301/ru.2010.5884.
The transsexual is a person who suffers from a deep identity disturbance caused by physical characteristics which do not correspond to mental traits and tendencies. The persistent sense of contradiction between his or her deceptive sexual appearance and his or her inner perception, causes a strong desire to achieve harmonization of the two. This aspiration, even if modification of chromosomal sex is impossible, can be fulfilled by undergoing SRS (Sex Reassignment Surgery). SRS represents the last major step of a clinical, therapeutic and diagnostic program involving skilled professionals in the physical and psychological sciences. Their assistance and counseling helps the patient to calmly and consciously decide to undergo SRS. A surgeon has the obligation not only to validate the operation outcome, but to also to maintain a long-term follow-up. A transsexual is not just like any other person; he or she should therefore be treated with sympathy and understanding. The surgeon should try his best to establish a relationship of mutual trust, taking into account the causes of anxiety and stress felt by the patient, and keeping in mind the ultimate objective, which is an improvement in the quality of life. At present, the most widely used surgical techniques are the Simple Penile Skin Inversion, the Penile-scrotal flap Inversion and the enterovaginoplasty. Each surgical technique has its own advantages and disadvantages, and it is up to the surgeon, in discussion with the patient, to make the appropriate choice. The surgical technique performing the Simple Penile Skin Inversion seems to ensure a better cosmetic appearance and an adequate lubrication, but a lower rate of satisfaction, in relation to the neocavity depth. On the contrary, the Penile-Scrotal Flap Inversion guarantees an adequate vaginal depth and lubrication, even though the cosmetic appearance is not always completely satisfactory. In our experience, a significant number of patients were satisfied with the chosen surgery and felt comfortable with their new post-operative gender. Taking into account all the complications involved, none of the patients did regret; actually, they would recommend the same operation to others. The overall results of some studies carried out on patient satisfaction before and after SRS show a marked post-surgery improvement of sexual life.
易性症患者是指因身体特征与心理特质和倾向不符而患有深度身份认同障碍的人。其外在欺骗性的性别表象与内在认知之间持续存在的矛盾感，引发了使二者达成协调一致的强烈愿望。即便无法改变染色体性别，这种愿望也可通过接受性别重置手术（SRS）来实现。性别重置手术是一个临床、治疗和诊断项目的最后关键步骤，该项目涉及物理和心理科学领域的专业技术人员。他们的协助与咨询能帮助患者冷静且理智地决定接受性别重置手术。外科医生不仅有责任确保手术效果，还需进行长期随访。易性症患者不同于常人，因此应给予同情和理解。外科医生应尽力建立相互信任的关系，考虑到患者所感受到的焦虑和压力的成因，并牢记最终目标，即提高生活质量。目前，应用最广泛的手术技术有单纯阴茎皮肤内翻术、阴茎阴囊皮瓣内翻术和肠道阴道成形术。每种手术技术都有其优缺点，由外科医生与患者讨论后做出合适选择。实施单纯阴茎皮肤内翻术的手术技术似乎能确保更好的外观和足够的润滑度，但就新阴道深度而言，满意度较低。相反，阴茎阴囊皮瓣内翻术能保证足够的阴道深度和润滑度，尽管外观并不总是完全令人满意。根据我们的经验，相当多的患者对所选手术感到满意，并对术后的新性别感到舒适。考虑到所有相关并发症，没有患者后悔；实际上，他们会向他人推荐同样的手术。一些关于性别重置手术前后患者满意度的研究总体结果显示，术后性生活有显著改善。
