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Do you use a penile-scrotal flap for vaginoplasty

Do you use a penile-scrotal flap for vaginoplasty?  I’ve read about this on line.  Marla

Dear Marla,

Glad we spoke, and realized we were talking about someone else’s web-site.  A flap is a transfer of skin or tissue in a pedicle like manner.  The vascular and hopefully nerve supply is maintained at the base of the flap.

The likelihood of survival is better than with a graft.  A graft involves harvesting (complete removal of skin or other tissue), re-siting it, and allowing the local environment to maintain viability by ultimate revascularization of the graft.

For enhanced  vaginal depth we do use a scrotal graft which is attached to the penile skin flap.  Some doctors, especially in the Orient will use the penile skin for labia minora and form the entire vagina with a tubularized scrotal graft.

Example #9: Male to Female Transsexual Surgery - Sequence in scrotal graft assembly to produce 7 to 8 inch depth, in a patient with otherwise short penile shaft length. 9/1

Scrotal graft after preparation

 

9/2
Scrotal graft tubularized

 

9/4
Scrotal graft attached to inverted penile skin flap, soon to be placed in the vaginal space.  The skin is on the inside.  Note: 3 to 4 inch extension for enhanced vaginal depth.

 

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