Sex reassignment surgery in HIV positive transsexuals

International Journal of Transgenderism

Volumn 3, Issue 1-2, 1999, Pages

  Wilson, A Neal ^a,b  

^a WAYNE STATE UNIVERSITY   (United States)

^b NONE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CD4 ANTIGEN;

HUMAN; HUMAN IMMUNODEFICIENCY VIRUS INFECTION; LYMPHOCYTE COUNT; MORTALITY; REVIEW; SAFETY; SEX TRANSFORMATION; SEXUAL BEHAVIOR; SEXUAL ORIENTATION; TREATMENT OUTCOME;

EID: 0002464588     PISSN: 14344599     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (3)

1. Flum DR, Wallack MK. (1997). The surgeon's database for AIDS: a collective review. Journal of the American College of Surgeons. 184(4):403-12.
2. Lowenfels AB, Mehta V, Levi DA, Montecalvo MA, Savino JA, Wormer, GP. (1933) Reduced frequency of percutaneous injuries in surgeons. AIDS. 9(2):199-202.
3. The details of the "Wilson" procedure have been available on the Internet for sometime. The procedure itself has not been written up for the hard copy literature as it is still evolving. Basically, the perineum is opened with the posterior perineal skin flap and the vagina is constructed. Bilateral orchiectomies are undertaken; the scrotum and penile skin are split in the mid-line leaving a rectangular penile skin flap; the penis itself is taken to pieces leaving the urethra and spongiosis ventral and separate; one third of one corpus cavernosa is dissected out and left to carry the vascular supply and nerve supply to a small segment of the original glans. The reconstruction is begun by first suturing in the posterior perineal skin flap, then suturing in the penile skin flap to the prostatic fascia and at each side to the posterior perineal skin flap, then bring through the urethra and the glans of the clitoris, bringing down the labia scrotal elements and suturing them to the mid-line. The raw vaginal vault is skin grafted one week later. A first graft dressing change is undertaken one week after this. The main advantage is that there is enough penile skin left on the outside to undertake reconstruction of labia minora and clitoral hood. The bulb of the penis can be removed later and the urinary stream adjusted to suit the patient. The clitoral shaft and the glans apparatus comes from above downwards rather than below upwards as in the simple penile inversions with the residual urethra. Erotic sensation to the glans is preserved.@