1129 SIR HAROLD GILLIES: PIONEER OF PHALLOPLASTY AND THE BIRTH OF UROPLASTIC SURGERY

Abstract

You have accessJournal of UrologyHistory of Urology1 Apr 20101129 SIR HAROLD GILLIES: PIONEER OF PHALLOPLASTY AND THE BIRTH OF UROPLASTIC SURGERY Rajesh Nair and Seshadri Sriprasad Rajesh NairRajesh Nair London, United Kingdom More articles by this author and Seshadri SriprasadSeshadri Sriprasad Kent, United Kingdom More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.2326AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Gender reassignment is described both in ancient Greece and Rome. Self-mutilation with crude surgical procedures was commonplace in order to appear the gender of desire. It was centuries later when Sir Harold Gillies, widely considered the father of plastic surgery, performed a series of operations on Michael Dillon. This completed the world's first female to male gender reassignment procedure. We examine the history of uroplastic surgery with reference to the technical, psychological and social challenges Gillies faced in pioneering phalloplasty. METHODS Time related sources from local and international media were reviewed. Manuscripts from the archives of the Wellcome History of Medicine Collection, Royal Society of Medicine, and the Centre of Anthropology of the British Museum, London were evaluated. RESULTS Modern gender reassignment surgery began in 1930, Berlin. Overseen by Dr. Magnus Hirschfeld, Lili Elbe underwent removal of his male sex organs. Despite four further operations he died following an unsuccessful uterine transplant. Work in gender manipulation was complemented with research in hormone treatments by Dr. Harry Benjamin, a New York endocrinologist. It was in London, England where Harold Gillies reconstructed penises in soldiers with blast injuries. His drive to perform a complete phalloplasty was delayed by the influx of World War II injuries. In 1946 however, British physician Laurence Michael Dillon (born Laura Maude Dillon) who felt “not truly a woman” consulted Gillies. A series of thirteen operations spanning four years culminated in the transformation of his external genitalia. The five stage procedure began by Gillies rolling a tube of tissue on the abdominal wall to produce a urethra. He surrounded this with another tube pedicle thereby, producing a composite homogenous penis. The upper end of the tube pedicle was then divided, and the new urethra anastamosed to the natural urethral aperture. The base of flap was adjusted and excess tissue discarded. The end of tube was then modelled to resemble the glans penis and the distal half of the penis thinned. This technique laid the foundation on which modern phalloplasty is based. Subsequently, Gillies went onto performed a flap technique female to male reassignment procedure, a method that has remained standard for forty years. CONCLUSIONS With its origins in ancient history, the reincarnation of gender reassignment surgery through Sir Harold Gillies's phalloplasty was pivotal. Despite ethical protest and media sensation, this unique procedure has culminated in the birth of modern uroplastic surgery. © 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e437 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rajesh Nair London, United Kingdom More articles by this author Seshadri Sriprasad Kent, United Kingdom More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...