Morel Journel N, Terrier J-E, Courtois F, Droupy S, Gorin-Lazard A
Centre hospitalier Lyon-Sud, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France.
Prog Urol. 2013 Jul;23(9):718-26. doi: 10.1016/j.purol.2013.01.021. Epub 2013 Apr 4.
Transsexual conditions need to be assessed for a psychological, hormonal and surgical evaluation. A multidisciplinary consent is required to perform hormonal and surgical treatment.
A critical overview has been performed (PubMed) and the main guidelines have been summarised.
Hormonal treatments include suppression of the naturally secreted hormone and the administration of hormone of the desired sex. The main comorbidity is thrombo-embolic complications for patients under oestogene therapy. The main surgical treatment for female to male (FtM) surgery are: periareolar mastectomy if possible, hysterectomy, ovariectomy and vaginectomy and phallic reconstruction including metaidioplasty and forearm or suprapubic phalloplasty dependant of patient's wishes. The main treatments for male to female (MtF) surgery are: prosthesis mammoplasty and vaginoplasty and for some facial feminisation. The results in term of global satisfaction are high despite a relatively high rate of complications as well.
Results in terms of well-being and psychological improvement justify this treatment despite its relatively high morbidity.
变性情况需要进行心理、激素和手术评估。进行激素和手术治疗需要多学科同意。
进行了一项批判性综述（通过PubMed）并总结了主要指南。
激素治疗包括抑制自然分泌的激素以及给予期望性别的激素。主要合并症是接受雌激素治疗患者的血栓栓塞并发症。女性变男性（FtM）手术的主要治疗方法有：如有可能进行乳晕周围乳房切除术、子宫切除术、卵巢切除术和阴道切除术以及阴茎再造术，包括阴囊成形术以及根据患者意愿进行前臂或耻骨上阴茎成形术。男性变女性（MtF）手术的主要治疗方法有：假体隆胸术和阴道成形术以及一些面部女性化手术。尽管并发症发生率相对较高，但总体满意度方面的结果很高。
尽管发病率相对较高，但在幸福感和心理改善方面的结果证明这种治疗是合理的。
