Lim S M
Ann Acad Med Singap. 1986 Jan;15(1):122-6.
A review was made of transsexual patients who presented at a clinic for treatment. A total of 154 patients were seen over 6 years. There were 16 female to male transsexuals and 138 male to female transsexuals. Psychiatric screening was a mandatory prerequisite. Hormonal treatment for the transsexual had been started with no exception, prior to consultation. The scope of surgery and its limitations were described to the patient. The female to male transsexual had to undergo a multistaged procedure that included mastectomy, hysterectomy, raising of the penile pedicle, mobilising of the pedicle, insertion of silicone stiffener, and use of testicular prosthesis. Urethral diversion was not attempted. The surgical technique for the male transsexual utilised an inverted U flap on the perineum. Bilateral orchidectomy was performed. The penile skin flap was filletted. The vaginal tunnel was created by sharp and blunt dissection. The urethra was mobilised and translocated. The excess scrotal skin formed the labia. The most serious complication that occurred was that of rectovaginal fistula. Other complications included vaginal stenosis, urethral stenosis and labial abscess.
对到一家诊所寻求治疗的变性患者进行了回顾性研究。6年间共诊治了154例患者。其中有16例女变男变性者和138例男变女变性者。精神病学筛查是一项强制性的前提条件。无一例外，变性者在咨询之前就已开始接受激素治疗。向患者描述了手术的范围及其局限性。女变男变性者必须接受多阶段手术，包括乳房切除术、子宫切除术、阴茎蒂抬高、蒂部游离、插入硅胶支撑物以及使用睾丸假体。未尝试进行尿道改道。男变女变性手术技术采用会阴倒U形皮瓣。进行双侧睾丸切除术。阴茎皮瓣被剥离。通过锐性和钝性分离形成阴道隧道。游离并移位尿道。多余的阴囊皮肤形成阴唇。发生的最严重并发症是直肠阴道瘘。其他并发症包括阴道狭窄、尿道狭窄和阴唇脓肿。
