Sex reassignment surgery in male to female transsexuals.

The operative technique used is first described by Stuteville, Pandya, and Arieff in 1971. The main principle of this technique is that the vagina is lined with inverted penile skin like a flap on an abdominal pedicle. All the erectile tissue is removed. In the follow-up, special attention was paid to the patients' reactions to the surgery and to the anatomical and functional results. There was only 1 patient who regretted having had the operation. All the others were well pleased and content that their external sexual organs at last fitted their body image. There were few complaints about the appearance, and only 4 patients needed further surgery to increase the size of the vagina. Some patients had a vagina that would be judged too small. They did not complain because the vagina was unimportant in their sexual activities.