Objective

Familiarize gynecologists with the basic steps of male-to-female transgender

surgery using the penile inversion vaginoplasty technique. 让妇科医生熟悉使用阴茎倒置阴
道成形术进行男变女变性手术的基本步骤。

1- a penoscrotal skin flap is created 制作一个阴囊皮瓣

permanent hair removal of the genitalia so that the future near vagina is hair free
对生殖器进行永久性脱毛，以便将来靠近阴道的地方没有毛发

this patient previously had a bilateral orchiectomy 这个病人以前做过双侧睾丸切除术（如果

没有，就在本手术中顺便做了）

2- ISOLATION OF URETHRA 尿道独立分离术

the urethra is dissected off the corpora cavernosa 将尿道从海绵体上剖下来。

the urethra is transected 横切尿道

the Foley catheter is replaced 更换 Foley 导尿管

3- EXCISION OF CORPORA CAVERNOSA 海绵体切除术

a tourniquet is placed around the corporal bodies to decrease blood loss; the
tourniquet will later be removed 在海绵体周围放置止血带，以减少血液流失；止血带随后将被移除。

4- CLITOROPLASTY 阴蒂成形术
the Neo clitoris is created from the glans penis 新阴蒂是由阴茎龟头产生的。

the Neo clitoris and neurovascular are secured in place 新阴蒂和神经血管被固定在原处

5- URETHROPLASTY 尿道成形术
the urethra is bivalved 将尿道口分为双瓣

the bivalve urethra is divided in its bed line and secured around the neo clitoris
双瓣尿道在其基线上分割，并固定在新的阴蒂周围。

6- VESICORECTAL DISSECTION 膀胱剖开

essica rectal dissection is necessary to create the vaginal cavity for the Neo
vagina 为创造新阴道的阴道腔，必须进行直肠剥离。

vagina extreme care is necessary during this part of the procedure as injury can
lead to future fistula formation and other complications
手术的这一部分需特别小心，因为损伤可能导致未来瘘管的形成和其他并发症。

gold a jewel length is 12 to 15 centimetres 适宜长度：12～15cm

7- PLACEMENT OF SSLF SUTURES 低位液线缝合

sutures are placed through the bilateral sacred sinus ligaments in the pelvis using
a suture carrying 使用缝合器，通过骨盆内的双侧圣窦韧带进行缝合

8- VAGINOPLASTY 阴道成形术
the penile and scrotal skin flaps together 阴茎和阴囊的皮瓣衔接在一起
bilateral sacred spinous ligaments in the pelvis are passed through the apex
骨盆中的双侧骶棘韧带通过顶点

9- VULVOPLASTY 外阴成形术
the penile portion of the craft is divided in the midline and placed over the Neo
clitoris and urethra 阴茎部分在中线上被分割开来，放在新的阴蒂和尿道口上。

the outer edge of the urethral epithelium is sutured to the Neo clitoris 尿道上皮的外
缘被缝合到新阴蒂上。

insert bilateral flat JP drains and suture the subcutaneous and sub particular
tissues to create the neo vulva 插入双侧平坦的 JP 引流管，缝合皮下特定组织以创造新的外阴。

the Foley catheter remains in place and a vaginal dilators placed to prevent
stricture of the Neo vagina
Foley 导尿管保持原位，并放置阴道扩张器以防止新阴道的狭窄。

Conclusion
• Although many gynecologists will not perform male-to-female transgender surgery,
knowledge of this procedure may translate to better understanding and improved care
of the transgender patient. - 尽管许多妇科医生不会进行男变女的变性手术，但对这种手术的了解可
能会转化为对变性病人的更好理解和更好的护理。