Meyer R, Daverio P J, Dequesne J
Department of Plastic Surgery, Centre de Chirurgie Plastique, Lausanne, Switzerland.
Ann Plast Surg. 1986 Jun;16(6):472-9. doi: 10.1097/00000637-198606000-00004.
Until now, phalloplasty in transsexuals has been done with cutaneous and musculocutaneous flaps from the abdomen or the thigh in multiple procedures over a long period. We report a one-stage phalloplasty in female transsexuals with a modified Chinese forearm flap, including the cutaneous nerves anastomosed to the genital branches of the ilioinguinal and iliohypogastric nerves and the perineal branches of the pudendal nerve to obtain true genital sensibility. Immediate hysterectomy and vaginal closure are performed, providing vaginal skin to complete the neoscrotum built up with the labia and to cover the glans. A vaginal flap draped around the catheter provides the urethra, which is stripped through the dermal tube of the forearm flap acting as a corpus spongiosum. Autogenous costal cartilage is used as a stent for reinforcement, substituting for the corpora cavernosa. The donor forearm area is covered with split skin.
到目前为止，变性者的阴茎成形术一直是通过腹部或大腿的皮瓣和肌皮瓣，分多个步骤、在很长一段时间内完成。我们报告了一种采用改良的中国前臂皮瓣对女性变性者进行的一期阴茎成形术，包括将皮神经与髂腹股沟神经和髂腹下神经的生殖支以及阴部神经的会阴支进行吻合，以获得真正的生殖器感觉。同时进行子宫切除术和阴道闭合术，利用阴道皮肤来完成由阴唇构建的新阴囊，并覆盖龟头。围绕导管的阴道瓣形成尿道，通过充当海绵体的前臂皮瓣的真皮管将尿道剥离出来。自体肋软骨用作加强支架，替代海绵体。供体前臂区域用断层皮片覆盖。
