Undertaker
Established
- Joined
- May 26, 2017
- Messages
- 159
"Testosterone suppression did you two big favors here, but it didn't do you any favors down below."
http://sci-hub.io/http://dx.doi.org/10.1016/j.jsxm.2017.02.007
”Anatomic and Physiologic Issues
There was little concern over the younger adolescent and her ability to physically withstand the invasive procedure compared with a middle-age or elderly patient; however, almost all surgeons remarked on the penoscrotal hypoplasia or limited penile shaft size that would ensue after the use of puberty-suppressing gonadotropin-releasing hormone analogues, sometimes for as long as 3 years. Two surgeons who reported operating on minors commented,“... they are coming in after being put on blockers,so they have 11-year-old genitalia” (surgeon 9) and“...you are really doing vaginoplasty on a micropenis” (surgeon 16). Most participants emphasized that the surgical techniques were the same for all patients no matter the age; of those who had per-formed the procedure on several minors, the use of flank skin grafts most commonly resolved the problem of inadequate tissue availability. In other reported measures, surgeon 2 implanted a scrotal tissue expander that required periodic infusion during 2 months, and surgeon 14 used donor tissue matrix (LifeCell, Branchburg, NJ, USA), deeming it “nicely successful” and thereby avoiding patient exposure to external flank scarring. The alternative procedure of using sigmoid- or ileum-derived grafts to create the neovagina was seen as a last resort by a few participants who stated diversion colitis, excessive secretion, persistent odors, and potential leakage of stool into the peritoneum as some of the concomitant morbidities."
http://sci-hub.io/http://dx.doi.org/10.1016/j.jsxm.2017.02.007
”Anatomic and Physiologic Issues
There was little concern over the younger adolescent and her ability to physically withstand the invasive procedure compared with a middle-age or elderly patient; however, almost all surgeons remarked on the penoscrotal hypoplasia or limited penile shaft size that would ensue after the use of puberty-suppressing gonadotropin-releasing hormone analogues, sometimes for as long as 3 years. Two surgeons who reported operating on minors commented,“... they are coming in after being put on blockers,so they have 11-year-old genitalia” (surgeon 9) and“...you are really doing vaginoplasty on a micropenis” (surgeon 16). Most participants emphasized that the surgical techniques were the same for all patients no matter the age; of those who had per-formed the procedure on several minors, the use of flank skin grafts most commonly resolved the problem of inadequate tissue availability. In other reported measures, surgeon 2 implanted a scrotal tissue expander that required periodic infusion during 2 months, and surgeon 14 used donor tissue matrix (LifeCell, Branchburg, NJ, USA), deeming it “nicely successful” and thereby avoiding patient exposure to external flank scarring. The alternative procedure of using sigmoid- or ileum-derived grafts to create the neovagina was seen as a last resort by a few participants who stated diversion colitis, excessive secretion, persistent odors, and potential leakage of stool into the peritoneum as some of the concomitant morbidities."