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      Urethral Complications After Transgender Phalloplasty: Strategies to Treat Them and Minimize Their Occurrence.

      1
      Clinical anatomy (New York, N.Y.)
      Wiley
      surgical flaps, transsexualism, urethra, urethral stricture

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          Abstract

          Radial forearm free flap phalloplasty (RFFP) is the current standard of care for most FTM gender confirmation surgeries. This procedure is associated with a rate of urethral stricture as high as 51%, which falls only to 23-35% even among the most experienced contemporary surgeons. While some modifications have been proposed to combat this high complication rate, it still remains a major source of lasting morbidity. The method involves literature review of RFFP literature. Lowest stricture rates are found when neourethra is made with a long, meticulously constructed tube of well-vascularized perivaginal/periurethral and labia minora tissue. In cases of urethral stricture, urethroplasty is required in 94-96% of patients. Surgery should be delayed until all acute inflammation has subsided. Urethroplasty is technically challenging and fails in up to 50% of cases. Repeated surgery or salvage urethral exteriorization procedures, which can leave the patient with lifelong perineal urethrostomy, are often required. Patient and physician knowledge regarding the high burden and poor treatment options for urethral stricture after phalloplasty is incomplete, and patient acceptance of this reality is crucial for honest understanding of the potential complications of this increasingly common but extremely complex surgery. Clin. Anat. 31:187-190, 2018. © 2018 Wiley Periodicals, Inc.

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          Author and article information

          Journal
          Clin Anat
          Clinical anatomy (New York, N.Y.)
          Wiley
          1098-2353
          0897-3806
          Mar 2018
          : 31
          : 2
          Affiliations
          [1 ] Brownstein Crane Surgical Services, Bee Caves Road, J201 Austin, Texas.
          Article
          10.1002/ca.23021
          29178533
          d058e5d6-d64a-4dbe-91cc-b07a373ec96e
          History

          urethral stricture,surgical flaps,transsexualism,urethra

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