PD40-12 COMPARISON OF TWO DIFFERENT APPROACHES IN CLITORAL RECONSTRUCTION DURING M TO F SEX REASSIGNMENT SURGERY

Abstract

You have accessJournal of UrologySexual Function/Dysfunction/Andrology: Surgical Therapy II1 Apr 2015PD40-12 COMPARISON OF TWO DIFFERENT APPROACHES IN CLITORAL RECONSTRUCTION DURING M TO F SEX REASSIGNMENT SURGERY Giovanni Liguori, Paolo Umari, Nicola Pavan, Michele Rizzo, Milos Petrovic, Stefano Bucci, Giorgio Mazzon, Giangiacomo Ollandini, Carlo Trombetta, and Emanuele Belgrano Giovanni LiguoriGiovanni Liguori More articles by this author , Paolo UmariPaolo Umari More articles by this author , Nicola PavanNicola Pavan More articles by this author , Michele RizzoMichele Rizzo More articles by this author , Milos PetrovicMilos Petrovic More articles by this author , Stefano BucciStefano Bucci More articles by this author , Giorgio MazzonGiorgio Mazzon More articles by this author , Giangiacomo OllandiniGiangiacomo Ollandini More articles by this author , Carlo TrombettaCarlo Trombetta More articles by this author , and Emanuele BelgranoEmanuele Belgrano More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2446AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Many surgical techniques have been described to consent transgenders to reach harmony between physical and mental state of being. In 2010 we introduced some improvements to our original peno-scrotal inversion technique especially in the costruction of neoclitoris. The aim of this study is to compare perioperative morbidity, aesthetical and functional satisfaction in patients undergone M to F Sex Reassignment Surgery (SRS) with our original (standard technique) and new technique (neourethroclitoroplasty). METHODS Between 2006 and 2014 123 consecutive M to F SRS have been performed at our Department by the same equipe. Patients were assigned into two groups. In the first group called Standard group (SG) 57 patients underwent M to F SRS with our original technique (period 2006-2009) and in the second group called Neourethroclitoroplasty group (NG) 66 patients underwent M to F SRS with our new technique (period 2010-2014). The main differences between the two surgical techniques are the clitoral-urethral complex construction, the size of the clitoris and its location relative to the neovagina. We retrospectively compared the operative time, hospital stay and perioperative complications. Aesthetical satisfaction was evaluated before and after SRS using a newly constructed questionnaire based on five-point Likert-type scale whereas the sexual functioning (sexual arousal, lubrification, orgasm, satisfaction and pain) was assessed using Female Sexual Function Index (FSFI). RESULTS The mean operating time was 312 minutes for the SG and 274 minutes for the NG; mean hospital stay was 10.5 and 12.8 days for SG and NG respectively. Perioperative complications between the two groups were comparable. In the new and improved technique the clitoris is larger and closer to the anterior neovaginal wall. The urethral flaps are used in continuity with the previously spatulated urethral plate in order to surround the neoclitoris and construct the urethral neoprepuce. No skin flap divides clitoris and urethra and there are no additional scars above the neoclitoris. Few months after surgery patients are able to appreciate some degree of wetness in the neoclitoris area and there is no hair growth. CONCLUSIONS Patients had undergone SRS with the new technique are very satisfied with the finally aesthetic result. The sexual functioning is higher in NG than SG and most of them reported ability to reach orgasm. The operative time, hospital stay and complication rates were comparable in both groups. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e839 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Giovanni Liguori More articles by this author Paolo Umari More articles by this author Nicola Pavan More articles by this author Michele Rizzo More articles by this author Milos Petrovic More articles by this author Stefano Bucci More articles by this author Giorgio Mazzon More articles by this author Giangiacomo Ollandini More articles by this author Carlo Trombetta More articles by this author Emanuele Belgrano More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...