涂懿美 譯


The radial forearm flap is an extensive procedure, which uses the skin, arteries and nerves of the forearm to make the penis. The new penis is then attached to the pubis by microsurgical techniques. The nerves of the clitoris are attached to the nerves of the skin of the penis. The urethra is brought out to the tip of the penis to allow the patient to stand to urinate. The principal advantages of this operation are that the appearance the penis is very good, one can stand to urinate, and the penis will usually develop sensation. One year later an erection device can be placed to allow for vaginal intercourse. On the other hand, this is a formidable operation with significant risk, including complete loss of the flap (approximately 5%), urinary leaks, and stricture. The scar on the arm can also be quite formidable, resembling a burn scar of the arm, and in many patients the major deterrent to this operation. Nevertheless, excepting the donor scar on the arm, the final result is probably the best from the aesthetic and functional standpoint of all the operations available. This is an operation that is a major undertaking and should be done at a center with a team of surgeons that routinely does them. The risks are profound and the complications can have long term implications.

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