The SRS Surgery information on this website is intended for general and education purposes only and should not be considered as expert advice. For any expert opinion you should consult a qualified medical practitioner, such as your own General practitioner.

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Sex Reassignment Surgery

"Sex Reassignment Surgery" allows an individual to change their gender.

These interventions, carried out by our service, are aimed at "transgender" patients, that is to say people whose gender - the psychic and social identity linked to the concepts of man and woman comes into conflict with their biological sex. Given the strong psychological impact of these interventions, surgeons, psychiatrists, endocrinologists and psychologists meet to assess the patient. Engaging in a gender reassignment process is a long journey, which involves heavy treatment, not just the operation.

MALE-TO-FEMALE REASSIGNMENT SURGERY

Vaginoplasty:

Vaginoplasty is surgery to get female genitals. Our team uses a surgical technique that includes a single step, namely penile inversion (the skin of the penis and testicles is grafted inside the vagina) coupled with the autograft of a neurovascular flap of the glans which will be used to create a sensitive clitoris.

During the operation, the surgeon:

• Will remove the skin of the scrotum, which will be thinned and rid of its hairs thanks to the cauterization of their roots;
• Will remove the testicles;
• Dissect the penis whose skin will be turned over to be grafted inside the vaginal cavity;
• Dissect the internal structures of the penis, taking care to separate the urethra, the corpora cavernosa and at the same time release a flap comprising blood vessels and nerve endings:
• The corpora cavernosa will be removed;
• The distal end of the preserved flap, in the shape of a “made-to-measure” island, will be taken directly from the glans to form the clitoris. The flap and the clitoris will be positioned and fixed;
• The urethra will be dissected; the remaining tissues will be preserved to line the inside of the labia minora, which will allow a more natural result to be obtained than if a skin graft was used.
• Will create the labia majora;
• Create the vagina by dissecting, to a depth of 14 to 17 cm on average, the tissues located under the urinary meatus and along the Denonvilliers fascia (space between the prostate and the rectum).
• Nerve recovery and the ability to achieve orgasms depend on the patient's age, lifestyle and overall health.

FEMALE TO MALE REASSIGNMENT SURGERY

Phalloplasty

Phalloplasty mainly involves removing a flap of skin from an area of ​​the body to create the phallus. The removal of this flap can be done in different places. The goal is to achieve the most realistic results both physically and functionally, including the ability to urinate while standing. The surgical technique currently performed by doctor is abdominal phalloplasty.

Planned and hoped-for results:

• Complete creation of the male external genitalia comprising a phallus of medium size, a glans and a scrotum;
• Construction of the penile urethra allowing standing urination;
• Possibilities of sexual intercourse with penetration following the placement of the penile implant.

Surgical technique:

An expansion balloon placement phase, two expansion balloons with implantable inflation chambers at the iliac ridges. On the 15th postoperative day, balloon inflation begins. The goal is to put between 500 and 800 ml per balloon, which makes an average of 7 postoperative inflation. The first inflation will be carried out at 15 days.

Following the placement of the balloons, 3 months later tubulization phase: actual creation of the phalloplasty which is attached at the bottom and at the top to allow good vascularization of the phalloplasty.

3 months later comes the release phase of the flap.

3 months later, creation of the urethra in the phalloplasty.

Then during a 5th operation, connection of the urethra of the abdominal phalloplasty to the native urethra. In this phase, we take the opportunity to perform the glanuloplasty and make the complementary vaginal closure if necessary, associated with possibly burying the clitoris if the patient so wishes.

6 to 12 months later, in the absence of complications, the penile implant and testicular prostheses are placed.

* The creation of the urethra is optional, it depends on the patient's willingness to urinate in "standing" position

The penile implant

Inserting the implant into the phallus that was formed during phalloplasty makes penetrative sex possible. Penile implant insertion is a surgical procedure in which the implant is inserted into the phallus that was formed during phalloplasty. Currently, we are working with 2 implant models. The model, the mechanism and the length will be chosen according to your anatomy. The penile implant obtains its rigidity by activating the pump normally located in the scrotum. The rigidity obtained makes sex with penetration possible. This procedure can be performed 6 months after the construction of the urethra.