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首页> 外文期刊>BJU international >Long-term outcome of forearm flee-flap phalloplasty in the treatment of transsexualism.
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Long-term outcome of forearm flee-flap phalloplasty in the treatment of transsexualism.

机译：前臂后翻瓣阴茎成形术的长期结果。

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OBJECTIVE: To assess the long-term outcome of forearm free-flap phalloplasty in transsexuals, as obtaining a satisfying neophallus in female-to-male transsexuals is a surgical challenge. PATIENTS AND METHODS: We analysed retrospectively 56 transsexuals who had a phalloplasty using a radial forearm free-flap in our department from 1986 to 2002. The complication rate was assessed by regular examination. Patient satisfaction was evaluated by a questionnaire about cosmetic aspects, sexual life and overall satisfaction. RESULTS: The mean follow up was 110 months; 53 of the 56 patients (95%) currently have a neophallus, after a mean of six surgical procedures. Satisfaction was assessed in 53 patients using a specific questionnaire: 51 (93%) of the patients reported that the phalloplasty allowed them to accord their physical appearance with their feeling of masculinity. There were flap complications in 14 patients (25%); three (5%) flaps were lost, with one each due to early haematoma, cellulitis and late arterial thrombosis. The other 11 flap complications were all transitory, e.g. infection, haematomas and vascular thrombosis. There were prosthesis complications in 11 of 38 patients (29%). Moreover, seven of 19 patients (37%) who had a urethroplasty presented with complex strictures and fistulae that led to perineal urethrostomy. CONCLUSION: Our study shows that phalloplasty with a forearm free-flap leads to good results in term of flap survival and patient satisfaction. However, there was a high rate of complications. Patients must be clearly informed that the procedure can seldom be achieved in one stage.
机译：目的：评估变性者的前臂自由皮瓣阴茎成形术的长期结果，因为在女性对男性的变性者中获得令人满意的新睑是一项手术挑战。病人与方法：我们回顾性分析了1986年至2002年间我科采用department骨前臂自由瓣进行阴茎成形术的56名变性者。通过常规检查评估其并发症发生率。通过有关美容方面，性生活和总体满意度的问卷调查评估患者的满意度。结果：平均随访110个月。在平均进行六次手术后，目前56例患者中有53例（95％）患有新眼球。使用特定的问卷对53例患者的满意度进行了评估：51例患者（93％）报告说，阴茎成形术可以使他们的外表与男性气质相匹配。 14例患者发生皮瓣并发症（25％）;丢失了三个（5％）皮瓣，每个皮瓣由于早期血肿，蜂窝织炎和晚期动脉血栓形成而丢失。其他11个皮瓣并发症均为暂时性的，例如感染，血肿和血管血栓形成。 38例患者中有11例存在假体并发症（29％）。此外，在接受尿道成形术的19例患者中，有7例（37％）表现出复杂的狭窄和瘘管，导致会阴尿道造口术。结论：我们的研究表明，前臂自由皮瓣的阴茎成形术可在皮瓣存活和患者满意度方面取得良好的效果。但是，并发症的发生率很高。必须清楚告知患者该过程很少在一个阶段完成。

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