IN THE MAY SURGERY SPOTLIGHT, William Kuzon, MD, demonstrates a genital sex reassignment procedure in a 41-year-old male. Dr. Kuzon discusses the importance of ensuring that patients for this procedure have met the criteria set forth by the World Professional Association for Transgendered Health (WPATH) including adaption to hormonal therapy and living full-time in the female gender for more than one year. Preoperatively, he also discusses the importance of confirming normal male anatomy with no testicular mass or in-groinal hernias, which would complicate the planned procedure.
In collaboration with a urologist, Dr. Kuzon demonstrates the procedure for designing the flap which will become the back wall of the new vagina, prior to dissecting the bulbocavernosus and identifying the juncture of the anal sphincter. He performs an orchiectomy and then the penis is degloved and the penile skin tube separated from the penile corporal bodies. The dorsal neurovascular bundle is isolated and a portion of the glans harvested to form the neo clitoris. The corpus spongiosum is then separated from the corpora cavernosa and a catheter inserted into the urethra. Dr. Kuzon demonstrates the blunt dissection of the new vagina and discusses the risks of rectal tear and rectal vaginal fistula. Finally, he demonstrates the placement of the neo clitoris on the midline, the anchoring of the penile urethra, the inversion of the penile tissue and the trimming and position of the remaining scrotal skin to form the new labia.
- Watch Dr. Kuzon perform this gender reassignment for free on PSEN.
- To view this surgery and earn up to 0.75 AMA PRA Category 1 Credit™, purchase the Surgery Spotlight: Penile Inversion Vaginoplasty online course.
Also this launched this month, Dr. Kuzon performs an approach for treating a condition known as “Buried” or “Hidden Penis.” In this instance, a 53-year-old patient had previously had difficulty with phimosis, had undergone a circumcision at a different institution and subsequently developed recurrent cicatrix difficulties with urination, hygiene and sexual function. Dr. Kuzon notes that while each patient’s treatment is personalized depending on the extent of the deformity, his general approach, demonstrated in this video, is to deglove the penile shaft, retrieve the corpora, and in combination with a superpubic lipectomy, anchor the corpora in a projected position with deep dermal sutures to the corpus cavernosum. This often requires skin grafting to the penile shaft. Watch Dr. Kuzon perform this procedure on PSEN.
Dr. Kuzon is the Reed O. Dingman Professor of Surgery in the Section of Plastic Surgery at the University of Michigan. He has performed a large number of gender-related procedures and is the director of surgical services at the University of Michigan Comprehensive Gender Services Program. In addition, Dr. Kuzon performs a wide array of surgical procedures, including the reconstruction of patients with facial paralysis, the management of difficult wounds, the management of patients after weight loss, and the management of defects resulting from the excision of sarcomas and other forms of cancer.
Past Surgery Spotlight programs remain freely available to view on PSEN. Hard copies of these programs can also be purchased from the PSEN DVD Library. Surgery Spotlight is a video-based product line produced by the Plastic Surgery Education Network (PSEN).