Reversal phalloplasty after regretful male to female gender reassignment surgery

Gender reassignment surgery is the last step in the transition procedure, and most transsexuals report satisfaction with its final outcome. Still, some patients regret their decision, requiring reversal surgery. [ view full abstract ]

Gender reassignment surgery is the last step in the transition procedure, and most transsexuals report satisfaction with its final outcome. Still, some patients regret their decision, requiring reversal surgery.

We present our results of reversal genital reconstruction in transgenders who underwent male-to-female reassignment surgery elsewhere, and regretted their decision afterwards. [ view full abstract ]

We present our results of reversal genital reconstruction in transgenders who underwent male-to-female reassignment surgery elsewhere, and regretted their decision afterwards.

Eight patients with previous male-to-female transsexual surgery, aged 33 to 53 years (mean age 41 year), underwent reversal surgery at our Center. Preoperatively, complete psychiatric and psychological assessment was done,... [ view full abstract ]

Eight patients with previous male-to-female transsexual surgery, aged 33 to 53 years (mean age 41 year), underwent reversal surgery at our Center. Preoperatively, complete psychiatric and psychological assessment was done, followed by proper endocrinological evaluation and treatment. Surgical procedure included three steps: removal of female genitalia, total musculocutaneous latissimus dorsi free flap phalloplasty and urethral reconstruction with insertion of testicular implants.

Final outcome was analyzed based on the esthetic appearance, complication rates, as well as patients' satisfaction. [ view full abstract ]

Final outcome was analyzed based on the esthetic appearance, complication rates, as well as patients' satisfaction.

Follow-up period ranged from 6 to 65 months (mean 26 months). Good postoperative outcome has been achieved in all cases. All surgical steps have been completed in five patients so far, and first and second step in remaining... [ view full abstract ]

Follow-up period ranged from 6 to 65 months (mean 26 months). Good postoperative outcome has been achieved in all cases. All surgical steps have been completed in five patients so far, and first and second step in remaining three, including one patient who does not want penile implants. Three cases of urethral fistula and one urethral stricture occurred in postoperative period, and have been successfully repaired 6-12 months after reversal surgery. There were no complications related to neophalloplasty, as well as penile implants. All patients reported satisfaction with the cosmetic outcome and improved psychological condition. They have all remained under continuous multidisciplinary follow-up.

Reversal surgery after regretful male-to-female sex reassignment surgery represents a complex, multistaged procedure with satisfactory outcomes. It is indicated only after proper psychiatric and endocrinological assessment.... [ view full abstract ]

Reversal surgery after regretful male-to-female sex reassignment surgery represents a complex, multistaged procedure with satisfactory outcomes. It is indicated only after proper psychiatric and endocrinological assessment. Multidisciplinary approach and long-term follow-up of these exceptional cases is necessary to improve selection process in persons eligible for gender reassignment surgery.