ABSTRACT
Male transsexualism is characterized by a life-long preference for the feminine role and the conviction of belonging to the female sex. The final and most characteristic expression of transsexualism is the desire to achieve the anatomical appearance of the opposite sex by either surgical or hormonal means. Since the skin graft technique of McIndoe, a number of operative procedures were evolved. Nowadays in order to construct neovaginas in male transsexuals, the inversion of penile flap or that of penile and scrotal skin flap is performed as a primary trial. Penile and scrotal skin flap have better functional results, but the cosmetic results are not satisfactory because of the prolapse of scrotal skin. In our studies, the vaginoplasty using penile and scrotal skin flap has been successfully used for 26 male transsexuals in whom their penis and scrotum were well preserved. We used scrotal skin flap modified by 8 cm wide. Additionally we made partial prepuce with dorsal neurovascular bundle into neoclitoris. Follow-up period ranged from 4 months to 22 months. The depth and width of neovagina was desirable. The cosmesis and physiologic benefit to the patient's satisfaction with the operation were reliable.