The transsexualism is defined as "a distribution of gender identity in which the person manifests, with constant and persistent conviction, the desire to live as a member of the opposite sex and progressively takes steps to live in the opposite sex role full-time."
Although its etiologty is unknown, the majority of modern psychiatrists and behavioral scientists agree that the transsexualism is a disease entity belonged to gender identity disorder, but not to be confused with the transvestite, homosexualism, or psychopaths.
We experienced five cases of male-to-female transsexualism. The basic requirements for this type of operation were that the patient be more than 21 years old, a transsexual for at least 3 years, cross dressing for more than 1 year and taking female hormones for at least 9 months.
The patient who approved himself a transsexualism by psychiatrists with psychological tests including MMPI, Rosarch test had recieved several preoperative studies including EEG to rule out temporal lobe epilepsy, excrtory urogram to rule out genitourinary abnormalities, sex chromation study with peripheral blood smear for diagnosis of genetically normal male person, and hormonal study(17-KS in urine) to rule out endocrine abnormalities.
Once the patient was admitted to the hospital , he was placed on a 2-day mechanical bowel preparation with a clear liquid diet.
The three male transsexuals underwent the vaginal reconstruction using one-stage penile skin flap inversion surgery after vaginal pocket dissection, and the other two transsexuals who had recieved penile amputation underwent modified McIndoe operation for vaginal reconstruction using full-thickness skin graft from inguinal area.
The ancillary procedures for male transsexuals including double fold operation, augmentation rhinoplasty, augmentation mammoplasty, facial bone contouring surgery, laryngeal chondroplasty, and electrolysis were also done, before of simultaneously.
Herein we describe the technique, mainly about vagnal reconstrution and briefly report the results
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