Anatomical implications of sex reassignment surgery in male-to-female transsexualism and follow-up study
Abstract
Aim: Greater acceptance of sexual minorities has enabled people with transsexualism access to adequate treatment and social integration. Gender reassignment surgery is a part of the complex care of transsexual patients.
In response to a greater volume of patients, surgical techniques have evolved and the outcome in patients with male-to-female transsexualism has become very similar imitation of female genitalia, enabling sexual intercourse with orgasm. The aim of this retrospective study was to evaluate the results of surgical reassignment of genitalia in male-to-female transsexuals.
Material and methods: The surgical techniques are described in detail. We performed a 3 month follow-up study of patients' opinions following gender reassignment surgery in 136 patients having a primary procedure (8 of whom had later sigmoideocolpoplasty) and 5 patients undergoing sigmoideocolpoplasty following an initial unsuccessful procedure at other units.
Results: All patients were satisfied with the first phase operation. Thirteen patients (9.2%) underwent successful sigmoideocolpoplasty Main complications were as follows: rectal lesions developing during preparation of the vaginal canal (1.4%); bleeding from the stump of the shortened urethra in the first 48 hours postoperatively requiring secondary suturing (4.3%); temporary urinary retention requiring repeated insertion of urinary catheters for up to 6 days (5%); and healing of the suture between the perineum and the posterior aspect of the vaginal introitus healing by secondary intention (5%).
The neoclitoris had erogenous sensitivity in 94,3% of patients and 67,6% reached orgasm in first 3 months. Conclusion: In conclusion, surgical conversion of the genitalia is a safe and important phase of the treatment of male-to-female transsexuals.