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To determine the possibility of providing alternative surgical techniques for male genital reconstruction and for maletofemale sex reassignment surgery, the authors undertook an anatomic investigation of the perineogenital region in male cadavers. Anatomic dissection was performed on 14 male adult human cadavers fresh and formalinpreserved studying the main afferent vessels to the anterior perineal region and their mean internal diameters deep external pudendal artery 0.60 mm, superficial perineal artery 0.50 mm, and funicular artery 0.37 mm. We established their exact topography, together with vascular anatomic variations, main vascular anastomosis circuits base of the penis, scrotal septum, and perineal fat and lateral spermaticscrotal fascia, angiosomes, anatomy of the rectovesical septum cavity, and their “critical” key points of dissection. The authors discuss the clinical possibility of elevation of a “tree” of previously described paragenitalgenital flaps including mainly those based on the terminal branches of the internal pudendal vascular system, the erectile tissue pedicled flaps, and finally, flaps of the external pudendal system. The authors indicate the concrete vascularization system for each flap. Plast. Reconstr. Surg.109 1301, 2002.

We report our experience in vaginoplasty for the treatment of six cases of the MayerRokitansky syndrome using bilateral vulvoperineal fasciocutaneous flaps measuring 8 to 9 X 3 cm. We consider a detailed description of the operative technique, noting the modifications that we have introduced as our experience increased, in addition to the cosmetic and functional results. On the other hand, the indications for using this vaginoplasty are presented.