Surgical Procedure
Female to male sex reassignment is done under general anaesthesia and takes between 7-9 hours of surgery. We prefer to perform all surgeries in one stage.
- Mastectomy
- Hysterectomy
- Ovarectomy
- Kolpectomy (exstirpation of the vagina)
- preparing a free forearm-flap (including vessels and nerves) with microsurgical technique
- creating a phalloplastic with a neo-urethra
- prolongation of the female urethra with the labia minores
- microsurgical anastomosis of arteries (end-to-side to femoral artery), veins (end-to-end to perisaphenic veins) and nerves (end to end to inguinal nerves) and anastomosis of the neo-urethra to the prolonged urethra, so that the phallus is situated in the midline similar to the normal male anatomy
- covering the forearm-flap-area of the arm with a full-thickness-skin-graft from the inguinal region or with skin from the mastectomy procedure.
- Preservation of the clitoris on the base of the phallus to maintain the ability to have an orgasm post-operatively. The ability to have an orgasm will be as good as pre-operatively. The clitoral organ is deepithelisized only and will be located at the base of the penoid, and covered with skin of the future scrotum. So during sexual intercourse the clitoris will be stimulated.
- Preparing the labia majora to allow for a scrotal prosthesis at a later time.