Twenty-two patients with gender dysphoria underwent neophalloplasties using a novel technique. A latissimus dorsi musculocutaneous reinnervated free flap was used to allow voluntary rigidity of the neopenis. From the first 22 patients, 18 have obtained motoric function of the reconstructed penis; a “paradox erection” was obtained. Fourteen patients came for the examination after a follow-up period of a mean of 26.4 months. We evaluated the motility and shape changes of the neophallus measuring its different size and dimension during relax and muscle contraction. The range of neophallus length in relaxed position was between 7 and 17 cm (mean 12.2 cm), its circumference in the same position ranged between 13 and 20 cm (mean 13.7 cm). All patients were able to contract the muscle with an average length reduction of 3.08 cm and an average circumference enlargement of 4 cm. In this study, the dimensions and motility were quantified demonstrating the neophallus function and size changes during sexual intercourse.

Department of Plastic and Cosmetic Surgery St Anne's Faculty Hospital Masaryk University Brno

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