[Transsexualism. IV. Surgical possibilities].
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Biomedical subjects
Publications and source records attributed to J J Hage.
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In the case of a female-to-male transsexual who has not yet undergone phalloplasty, one of the greatest concerns is how to give the appearance of having male external genitals. Many methods have been attempted by patients. We helped develop a silicone prosthesis after obtaining information on the demands of female-to-male transsexuals through a questionnaire sent to 120 of them. Three different models of the prosthesis were designed to enable three different methods of fixation. One of the methods of fixation involves the creation of a bipedicled skin flap in the pubic area. Thus this is the first of such prostheses that can be worn directly fixed to the body. It seems that the prosthesis developed in close cooperation with our department fulfills most of the needs of our patients.
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The buried penis is a rare congenital anomaly in which a circumcision can result in deformity and functional disorder of the penis. We describe the case history of a one-year-old boy with this anomaly who underwent ritual circumcision by a layman.
In the emergency room, as well as during elective surgery, the surgeon is often confronted with an absolute skin defect. In the older books on hand surgery the inner, volar aspect of the forearm was advised as a suitable donor area for skin grafts of either split or full thickness. Nowadays, the disfigurement in the donor area is considered unjustifiable. Since it is almost impossible to correct these scars more suitable donor sites have to be looked for. Some areas are suggested. It is advised to avoid the forearm as a routine donor area in case of skin defects in the hand.
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From 1980 to 1989, 13 male to female transsexuals underwent surgery for resection of the corpus spongiosum, performed at the Department of Plastic and Reconstructive Surgery of the Free University Academic Hospital, Amsterdam, The Netherlands. Except for 1, all patients underwent the primary sex-reassignment procedures in institutions other than this hospital. All had difficulties during sexual activities. After repeat surgery with near complete excision of the corpus spongiosum and also in three instances of the corpus cavernosum, improvement was noticed in all patients. The importance of the total elimination of the erectile tissue is emphasized.
Forty patients underwent surgical depilation for pseudofolliculitis barbae or local hirsutism of the face during a 15-year period. The operative method and its results and pitfalls are discussed. Although it is not the treatment of choice, this operation is very useful when other therapy has not been successful. This seems especially true in male-to-female transsexuals.
Unlike dislocations of the distal or proximal interphalangeal joints, the simultaneous dislocation in a single finger of both seems to be a rare occurrence. Reduction and checking of the collateral ligament, extensor tendon, and volar plate, followed by 3 weeks of splinting in the intrinsic plus position seems to be the treatment of choice.
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We describe a new incision for use in ray amputation. A semi-oval flap of skin from one side of the proximal phalanx of the finger to be amputated is preserved so that when the adjoining finger is transposed to fill the gap, the complete web can also be transposed. This avoids scarring in the web space.