Sigurjónsson Hannes, Möllermark Caroline, Rinder Johan, Farnebo Filip, Lundgren T Kalle
Department of Plastic and Reconstructive Surgery, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden.
Department of Plastic and Reconstructive Surgery, Karolinska University Hospital, Stockholm, Sweden.
J Sex Med. 2017 Feb;14(2):269-273. doi: 10.1016/j.jsxm.2016.12.003. Epub 2017 Jan 10.
A cornerstone of treating gender dysphoria for transgender women is gender reassignment surgery (GRS) encompassing vaginoplasty and clitoroplasty. The neoclitoris is harvested as a flap with a neurovascular pedicle from the proximal dorsal part of the glans penis. Few long-term follow-ups exist on postoperative sensation and patient-reported sexual functionality of the neoclitoris.
To examine the sensitivity of the neoclitoris and its relation to orgasm and sexual function at least 1 year after GRS.
Twenty-two patients were included, with a mean follow-up of 37 months (range = 12-63) after initial surgery. Tactile and vibratory sensitivities were measured with Semmes-Weinstein monofilaments and the Bio-Thesiometer vibratory measurement device, respectively. A questionnaire was provided to the patients, as were interview questions about body image, orgasm, pain, and general satisfaction with the surgery.
Tactile and vibratory sensitivities of the neoclitoris and questionnaire on satisfaction with orgasm, sexual function, and general satisfaction.
The average tactile threshold for the clitoris was 12.5 g/mm and the average vibratory threshold was 0.3 μm. Most participants (86%) experienced orgasm after surgery, had no or little pain, and were satisfied with the surgery. No statistical correlation was found between better or worse objective pressure and vibratory thresholds and patient answers to questions about the clitoris in the Body Image Scale for Transsexuals questionnaire.
The neoclitoris derived from the glans penis in GRS provides long-term clitoral sensation that is erogenous. Overall, the vast majority of patients who undergo male-to female GRS experience orgasm and are satisfied with the surgery.
对于跨性别女性而言，治疗性别焦虑症的一个基石是性别重置手术（GRS），包括阴道成形术和阴蒂成形术。新阴蒂是从阴茎头近端背侧作为带有神经血管蒂的皮瓣获取的。关于新阴蒂术后感觉和患者报告的性功能的长期随访很少。
在性别重置手术后至少1年，检查新阴蒂的敏感性及其与性高潮和性功能的关系。
纳入22例患者，初次手术后平均随访37个月（范围 = 12 - 63个月）。分别使用Semmes - Weinstein单丝和生物感觉阈值测量仪振动测量装置测量触觉和振动敏感性。向患者提供了一份问卷，以及关于身体形象、性高潮、疼痛和对手术总体满意度的访谈问题。
新阴蒂的触觉和振动敏感性以及关于性高潮满意度、性功能和总体满意度的问卷。
阴蒂的平均触觉阈值为12.5 g/mm，平均振动阈值为0.3μm。大多数参与者（86%）术后经历了性高潮，没有或只有轻微疼痛，并且对手术满意。在变性者身体形象量表问卷中，客观压力和振动阈值的好坏与患者关于阴蒂问题的回答之间未发现统计学相关性。
性别重置手术中源自阴茎头的新阴蒂提供了长期的性感的阴蒂感觉。总体而言，绝大多数接受男变女性别重置手术的患者经历了性高潮并对手术满意。
