Departamento de Urologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brasil.
Int Braz J Urol. 2018 Mar-Apr;44(2):407-408. doi: 10.1590/S1677-5538.IBJU.2017.0044.
After the diagnosis of transsexualism is confirmed therapy commences with psychotherapeutic preparation for the conversion, and after conversion, long-term patient rehabilitation is maintained for at least two years. The indication for surgery is chronic discomfort caused by discord with the patient's natural gender, intense dislike of developing secondary sex characteristics and the onset of puberty. The surgical conversion of transsexuals is the main step in the complex care of these problematic patients (1). This surgery was first described by Benjamin H, using a flap of inverted penile skin (2) and is considered the gold standard since then. Male-to-female transsexual surgical techniques are well defined and give good cosmetic and functional results. Sex reassignment surgery promotes the improvement of psychological aspects and social relationships as shown in the World Health Organization Quality of Life Assessment applied in the patients submitted to this procedure (3). Techniques include the creation of a normal appearing female introitus, a vaginoplasty allowing sexual intercourse and the capability of clitoral orgasm (4). Various methods for neovaginoplasty have been described and can be classified into five categories, i.e. pedicled intestinal transplants, penile skin grafts, penile skin flaps, non-genital skin flaps and non-genital skin grafts (5). In our Hospital, we use penile and scrotal skin flaps. Until now, 174 procedures have been performed by our team using this technique with high rates of satisfaction (3).
We present a step-by-step male to female transsexual surgery.
Surgical gender reassignment of male transsexuals resulted in replicas of female genitalia which enabled coitus with orgasm (1). With this video we show step by step that a surgery using penile skin flaps is able to be performed with good cosmetic results.
在确定跨性别者的诊断后，治疗即开始进行性别转换的心理准备，转换后，至少需要两年的长期患者康复治疗。手术的指征是由于与患者自然性别不符、强烈反感第二性征的发育和青春期的到来而导致的慢性不适。跨性别者的手术转换是这些有问题的患者的综合护理的主要步骤（1）。这项手术最初由 Benjamin H 描述，使用阴茎皮肤的翻转皮瓣（2），从那时起被认为是金标准。男变女的跨性别者手术技术已经得到很好的定义，并且可以获得良好的美容和功能效果。性别重置手术可以促进心理和社会关系的改善，正如世界卫生组织生活质量评估应用于接受该手术的患者中所显示的那样（3）。技术包括创建一个外观正常的女性阴道入口、允许进行性交的阴道成形术和阴蒂性高潮的能力（4）。已经描述了各种阴道成形术的方法，可以分为五类，即带蒂肠移植、阴茎皮片移植、阴茎皮瓣、非生殖器皮瓣和非生殖器皮片移植（5）。在我们医院，我们使用阴茎和阴囊皮肤瓣。到目前为止，我们的团队已经使用这种技术完成了 174 例手术，满意度很高（3）。
我们展示了一步一步的男性到女性跨性别者手术。
男性跨性别者的手术性别重置导致了女性生殖器的复制品，从而能够进行有性高潮的性交（1）。通过这个视频，我们一步一步地展示了使用阴茎皮瓣的手术可以获得良好的美容效果。
