涂懿美 譯

·  STAGE ONE 第一步


A pedicled flap is a tube of skin created from either the flank area or lower abdomen to construct a phallus. My preference is to use the groin flap, since this usually scars well, and doesn't require the use of skin grafts. This operation does require several stages. The first is the creation of a phallus, which is attached to the pubis and to its site of origin much like a "suitcase handle". This is done as an outpatient procedure, but I prefer that the patients stay overnight in the hospital as a guest in the VIP section.

·  STAGE TWO 第二步


The secondary procedure is called a "delay" and is meant to improve the blood supply of the penis. This minor procedure is done one month after the original procedure to partially separate the flap from the flank. The delay can be done in my clinic operating room. Patients need to stay one night in Portland. n Portland. A minimum of one surgical delay is necessary. Following this, the patient can enhance the blood supply, at home, by using a temporary tourniquet around the base.



Approximately three months after the first operation, secondary procedures can be done. For example, a glans can be sculpted on the phallus, an inflatable erection device can be placed to allow vaginal intercourse, or a scrotum can be formed. Each of these procedures must be done separately to preserve the blood supply to the flap. All are outpatient procedures that require one night in Portland. The principal advantage of this operation is that it does provide a penis of significant size and bulk. Following creation of the glans, it can also look quite natural. The final scar is located over the flank area and usually heals quite well. The greatest disadvantage is that the penis will lack sensation. Because this flap must re-establish its blood supply from the pubis, it has a more tenuous blood supply than the microsurgically created radial forearm flap. Therefore, there is a risk of the flap dying when it is separated from the groin. This is the reason that I use the delay operations to enhance the blood supply, and when using the above described schedule the operation is very reliable. Since the shaft of the penis is insensate, the erectile device will also have a greater risk of eroding through the penile skin. Lengthening of the urethra is ill advised in this operation, because there is a profound risk of problems including strictures or abnormal drainage of the urine (fistula).

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