Ability for Sexual Intercourse Without a Prosthesis

[David Man]

Hello,
I found this web site, I don't know if is the truth, or what... So I share it with you and you told me if you know more about this topic.
http://www.phallo.net/procedures/reinnervated-latissimus-dorsi-free-flap.htm
Thank you.

[David Man]

I'm sorry. I didn't know I can't post external links.
I found this site and I got curious, and I wanted to ask you if you even heard about this.


MLD Phalloplasty
Re-innervated Latissimus Dorsi Free Flap Phalloplasty
Re-innervated Latissimus Dorsi Free FlapNovel Phalloplasty Procedure Gives Patients Ability for Sexual Intercourse Without a Prosthesis.
This MLD phalloplasty technique gives the patient ability for having sexual intercourse without the need for prosthesis. The voluntary contraction of the phallus appears soon after the surgery, and this leads to the changes of diameter length and shape - the "paradox erection" (a stiffening, widening and shortening of the penis.) Some patients are able to take advantage of these properties for sexual intercourse.

In a 2008 study led by Dr. Ranno at Masaryk University, Brno, Czech Republic, the latissimus dorsi musculocutaneous reinnervated free flap was used in phalloplasty surgeries to allow voluntary rigidity of the neopenis. From the first 22 patients, 18 obtained motoric function of the reconstructed penis. The researchers concluded that this voluntary contraction of the penis is a consequence of the re-innervation of the transferred muscle, and the contraction is strong enough to stiffen the penis.

The described technique allows for subsequent reconstruction of the urethra if the patient desires.

Surgeons who offer this type of phalloplasty:

Dr. Veselý (CZ)
Dr. Justan (CZ)



Like I said, I never heard about this matter, I don't know if they are liars or genius, I couldn't find any more information. But if is possible have a penis with erections without a protresis it will be great!!!

[blink]

I'd never heard of this. It's definitely an interesting concept, thanks for posting about it.

[aleon515]

Yes, I have heard of it at a session on lower surgery at Philly Trans health. There are only a couple surgeons doing this procedure who I think you listed. Not sure if someone else is learning this.

--Jay

[Tysilio]

I've seen a few pictures on the surgeons' websites, and the results don't look very nice: pretty much like someone sewed on a salami...

[Marcellow]

I checked the results of such surgeries, oh my goodness. Graphic!

[palexander]

the penis is too thick....

[blink]

Dude, Tysilio.

For one, bottom-op result photos are often not "finished" - possibly not fully healed, may be pre-glansoplasty (a good glansoplasty can make a major difference in aesthetics), etc.
Regardless, if you don't find the results to your personal preference, there are ways to express that without so much disrespect.
Couple of quick examples, "The results aren't to my personal preference", "Interesting, but it's not for me", or even something in the vein of, "It's good to see there are surgeons working on creating more options for trans men".

Those are real people's bodies you're talking about. It takes guts to share something so personal with the internet. It's quite possible some of them read these forums, and even if that's not the case, not cool. Small wonder so few bottom-op guys share their results. If top surgery results openly mocked the way bottom surgery results often are, not many guys would want to share that either.

[Tysilio]

Regardless, if you don't find the results to your personal preference, there are ways to express that without so much disrespect.
Couple of quick examples, "The results aren't to my personal preference", "Interesting, but it's not for me", or even something in the vein of, "It's good to see there are surgeons working on creating more options for trans men".

But none of those are what I actually think about those particular pictures. My comment wasn't intended as mockery, just as a vivid description of my own observation/opinion.

It's interesting to me that the unfortunate "politically correct" ethos of never criticizing, of never speaking difficult truths in case unspecified people might have their feelings hurt, has carried over so strongly from doctrinaire PC feminism to trans politics. And, yes, I do see this as a political issue, to the extent that one set of people are claiming, in effect, the power to silence others.

Had you responded with something like:  "Tysilio, it could be that pictures showing results after the surgical process is farther along might change your mind about the aesthetics of this procedure," that would have been a fine way of expressing your disagreement with my opinion, and for us to have an actual conversation; but I think it's pretty "disrespectful" for you tell me what I should have said, and thus, in effect, what I should think.

It's possible for people to have a polite conversation about matters over which they disagree; among other things, that's how people learn from each other. I hope we can do that, blink, because I respect your intelligence and your views, even if we don't always see eye to eye.

[blink]

But none of those are what I actually think about those particular pictures. My comment wasn't intended as mockery, just as a vivid description of my own observation/opinion.

Whether it was intended as mockery doesn't change that it is unnecessarily hurtful. Everyone is entitled to an opinion, but not every opinion simply must be published, for all to see, without any editing or consideration for others. Especially on a support forum. I hold some opinions that would be offensive to some folks on here, but it's not necessary or helpful in any way for me to post them here, so I do not post them here.

Here's my observation: the last time I saw a description like that of FTM bottom surgery results, it was in a rather vulgar, anti-trans article. Take from that what you will. What I take from it, is that it is not the sort of comment well-suited to a transsexual support group.

It's interesting to me that the unfortunate "politically correct" ethos of never criticizing, of never speaking difficult truths in case unspecified people might have their feelings hurt, has carried over so strongly from doctrinaire PC feminism to trans politics. And, yes, I do see this as a political issue, to the extent that one set of people are claiming, in effect, the power to silence others.

Unspecified people? These are not hypothetical persons made up to discuss politics. Behind every surgical result photo, there is an actual human being. That picture is of part of their body.

I expressed disapproval of an unnecessarily crude comment on bottom surgery results, which was posted on a support board sub-forum dedicated to bottom surgery. I offered examples of more respectful ways of expressing dislike for surgical results - effectively encouraging you to express dislike for results, since I was providing suggestions for more ways to do that. You have likened that to trying to silence you, and censor your thoughts to preserve the feelings of unspecified persons.

Had you responded with something like:  "Tysilio, it could be that pictures showing results after the surgical process is farther along might change your mind about the aesthetics of this procedure," that would have been a fine way of expressing your disagreement with my opinion, and for us to have an actual conversation; but I think it's pretty "disrespectful" for you tell me what I should have said, and thus, in effect, what I should think.

Show me where I said you "should" have done anything, much less told you what to think.

For one, bottom-op result photos are often not "finished" - possibly not fully healed, may be pre-glansoplasty (a good glansoplasty can make a major difference in aesthetics), etc.
Regardless, if you don't find the results to your personal preference, there are ways to express that without so much disrespect.
Couple of quick examples, "The results aren't to my personal preference", "Interesting, but it's not for me", or even something in the vein of, "It's good to see there are surgeons working on creating more options for trans men".

Those are real people's bodies you're talking about. It takes guts to share something so personal with the internet. It's quite possible some of them read these forums, and even if that's not the case, not cool. Small wonder so few bottom-op guys share their results. If top surgery results openly mocked the way bottom surgery results often are, not many guys would want to share that either.

I stated that there are ways to express dislike of surgical results, without being disrespectful (statement of fact).
I provided examples of more respectful ways to voice a dislike for surgical results, and expressed disapproval of such "vivid descriptions" of one's impressions.
"Should" is nowhere in my post.

But let's say for the sake of argument, that I had said, "Tysilio, next time try something like this." We are able to think something without posting it, so it's a gross exaggeration to compare telling someone to be more polite in their posts on a forum, to telling them what to think.

It's possible for people to have a polite conversation about matters over which they disagree; among other things, that's how people learn from each other. I hope we can do that, blink, because I respect your intelligence and your views, even if we don't always see eye to eye.

I agree. As far as I am aware, that is exactly what we are doing here. Your comment regarding surgical results was, however, not polite. I hope you'll consider putting as much consideration and politeness - if not more - into critiquing others' surgical results, as you do into expressing disagreement with my views.

[Tysilio]

Blink, let me clarify one thing: I would never have written the description I did if those pictures had been posted by the individuals who had the surgery. I agree that that would have been extremely insensitive. But that's not the case; the pictures in question were from journal articles referenced in the link David provided in the OP. Given the stated follow-up intervals of up to several years, I think one can assume that the pictures represent the surgeon's best, and finished, results. Obviously they were published with the patients' permission; nonetheless, there's a difference between images published in a journal article, or posted for advertising purposes on a surgeon's website, and those an individual chooses to post of himself.

I've seen some amazing-looking phalloplasty outcomes, but this procedure's results fall well short of those. I'm sure that for some guys, the ability to have an erection of sorts outweighs the aesthetic shortcomings; but those shortcomings are considerable, and I don't think it's rude or hurtful to point that out in a thread that's about the technique itself, and not about a particular person's experience. 

[blink]

Blink, let me clarify one thing: I would never have written the description I did if those pictures had been posted by the individuals who had the surgery. I agree that that would have been extremely insensitive. But that's not the case; the pictures in question were from journal articles referenced in the link David provided in the OP. Given the stated follow-up intervals of up to several years, I think one can assume that the pictures represent the surgeon's best, and finished, results. Obviously they were published with the patients' permission; nonetheless, there's a difference between images published in a journal article, or posted for advertising purposes on a surgeon's website, and those an individual chooses to post of himself.

I've seen some amazing-looking phalloplasty outcomes, but this procedure's results fall well short of those. I'm sure that for some guys, the ability to have an erection of sorts outweighs the aesthetic shortcomings; but those shortcomings are considerable, and I don't think it's rude or hurtful to point that out in a thread that's about the technique itself, and not about a particular person's experience.

Right here.
You just expressed your opinion articulately, clearly, without being crude about it. When you say it like that, no, it isn't rude. Comparing someone's surgical results to sewn-on meat product is rude, and unnecessarily so, as you just demonstrated.

What difference does it make if the guy posted it himself, vs. gave someone else permission to publish it? How is it "extremely insensitive" if he posted it himself to liken his surgically created penis to an attached salami, but if someone else published it with his consent, suddenly it is A-OK? At the end of the day, he elected to share his surgical result with others, and surely seeing such a comment would affect him the same way regardless of who posted the picture.

One of these guys wouldn't see this thread and say, "Oh, this guy thinks my surgical outcome looks like sewn on salami, but I'm not at all offended, because it was published in a journal with my permission, instead of on my personal blog account. Now, if I'd posted it myself I'd be bothered."

Even if none of the surgical patients in question ever saw the remark, the fact that a trans man, on a support website for trans people, would publically post something like that lends to the idea that it's alright to talk about trans people's bodies this way. I'll say it again, the last time I saw a description like that it was in a particularly bad anti-trans article. The author was fond of likening bottom surgery results for trans men to attached sausages. Are you saying it was alright and 100% respectful for the author to write those things, as long as he was commenting on photos published in a surgical journal?

[Tysilio]

Blink, clearly you were offended by what I wrote, and I apologize for that.

[and now back to your regularly scheduled thread.... ]

[blink]

Blink, clearly you were offended by what I wrote, and I apologize for that.

[and now back to your regularly scheduled thread.... ]

Thanks for your concern, but as I've clearly stated, my objection is a matter of finding the comment counterproductive to a support forum (and in general). You're quite right, however, this has gotten off topic. Thanks for pointing that out. Sorry, folks.

[aleon515]

I don't know why surgeons for lower surgery don't ask their patients to send them photos a year out or something. I feel that the results are usually not good looking one- two months out at all, but might look very normal after a year or two.

The other thing is that it's too bad more surgeons aren't doing this one because the good aesthetics come not from which donor site, afaik, but from other things like building up of a glans and so on. Unless there is something specific to that area that would make it less aesthetic.


--Jay

I've seen a few pictures on the surgeons' websites, and the results don't look very nice: pretty much like someone sewed on a salami...

[Tysilio]

The other thing is that it's too bad more surgeons aren't doing this one because the good aesthetics come not from which donor site, afaik, but from other things like building up of a glans and so on. Unless there is something specific to that area that would make it less aesthetic.

I don't think it's specific to that donor site, as I've seen perfectly acceptable results when that site was used in a more conventional procedure, without trying to restore the contractile properties of the muscle. However, my impression from reading the published articles, especially the one in which they measure function, is that the "erectile" function -- voluntary contraction of the relocated trapezius muscle -- may limit the possibilities for improving the aesthetics via additional procedures. It's a little hard to describe, but if you look at the pictures, they show that the neophallus flexes and gets shorter and thicker when it contracts, and the tip, especially, changes its shape.