Hage J J, Bouman F G, Bloem J J
Department of Plastic and Reconstructive Surgery, Academic Hospital, Free University, Amsterdam, The Netherlands.
Plast Reconstr Surg. 1993 Jun;91(7):1303-7. doi: 10.1097/00006534-199306000-00017.
One of the goals of phallic construction in female-to-male transsexuals should be the creation of a competent neourethra that allows patients to void while standing. Apart from constructing the perineal fixed part of the neourethra, it is therefore necessary to create a phallus with a pendulant part of the neourethra to be connected to the pars fixa urethrae. In patients in whom we apply microsurgical free-flap techniques for phalloplasty, the pars pendulans is usually created the Chinese way (n = 8). If, on the other hand, pedicled abdominal or inguinal skin flaps are used, a skin-lined urethral tube to be incorporated in the phallus should already be extant in the donor area of the flap (n = 25). In the 20-year period 1971-1991, such a preconstruction of the pars pendulans urethrae has been attempted in 25 female-to-male transsexuals employing Snyder's technique. This has been successful in all and uneventful in 17 patients. If malelike micturition while standing is the goal and the use of microsurgical free-flap techniques is not indicated, this procedure seems to be the method of choice.
对于女变男的变性者来说，阴茎构建的目标之一应该是造出一个功能良好的新尿道，使患者能够站立排尿。因此，除了构建新尿道的会阴固定部分外，还需要造出一个带有可下垂新尿道部分的阴茎，以便与尿道固定部分相连。在我们对阴茎成形术应用显微外科游离皮瓣技术的患者中，下垂部分通常采用中国式方法构建（n = 8）。另一方面，如果使用带蒂腹部或腹股沟皮瓣，皮瓣供区应已有一个内衬皮肤的尿道管，以便纳入阴茎（n = 25）。在1971年至1991年的20年期间，我们采用斯奈德技术对25名女变男的变性者尝试了这种尿道下垂部分的预构建。所有患者均获成功，17例患者过程顺利。如果目标是实现站立时类似男性的排尿，且不适合应用显微外科游离皮瓣技术，那么该手术似乎是首选方法。
