The goal of female to male gender reassignment surgery is to create a male body, with appropriate external genitalia. Said genitalia should permit normal urinary function (i.e. urinating from a standing position) and satisfactory erogenous stimulation. To achieve this, there are two general types of surgical technique: metaidoioplasty and phalloplasty.
The phalloplasty is the surgical technique that allows the reconstruction of an anatomical dimensions phallus, this will use tissue from other parts of the body, usually the forearm skin and fat but can also be used, among others, tissue thigh or abdomen. This presents a very neopenis anatomical allows urination bipedal and erogenous tactile features but to allow sexual penetration will require a prosthesis must be implanted in a second time.
• The intervention
Phalloplasty using tissue from other parts of the body, usually in the forearm skin and fat to recreate a penis anatomical dimensions that, once shaped, will be transported to its final position where they will, through the microscope, the suture arteries and veins, which bring blood and nerves that give you tactile and erogenous sensitivity, the latter will get it thanks to a nerve of the clitoris that will overlap to one of the nerves of neopenis and, alongside the clitoris itself will remain buried under the phallus itself.
This technique is performed under general anesthesia and usually lasts for 10-12 hours.
To prolong the urethra in the first few centimeters the surgeon will use a graft of the anterior vaginal wall (with a length of approximately 5 centimeters and a width of 2 to 3 inches) and a flap lower lip skin, then sutured to the urethra previously created in the phallus.
During the same operation, the labia are mobilized and united dorsally in the midline to form a new scrotum. Once the scrotum, are placed silicone testicular implants, implantation of testicular prostheses can be performed during the same surgical procedure or be postponed to a second intervention in surgical judgment function.
• The recovery
After the first 48h allows the mobilization of the patient.
Even though you will be discharged one week after surgery, the patient must wear a catheter for at least 21 days. Occasionally, at the discretion of the surgeon can place a suprapubic, it allows avoiding bladder emptying urine flow through the urethra, keeping it dry in the early stages of recovery.
The most common complications that may occur include:
• Bleeding: It is possible to experience a bleeding episode during or after surgery.
• extrusion of the testicular prosthesis.
• urethra-cutaneous fistula: a report of the urethra with the scrotal skin.
• Urethral stricture decreased diameter of the urethra.
• vesico-vaginal fistula: communication between the bladder and vagina