The 9th edition

The 9th edition 

In this edition  we study more on, the  vascular  and  nerve supply  of  the scrotal flap to  make  the  posterior  flap. We preserve and meticulous dissected the flap to  make  more senstive  and survived posterior flap .The posterior flap will be  thicker  and  perineal vss is dissected to the flap until  the separation of deep artery and  dorsal  artery. After the  artery is  brought  togeter  to  the flap, less congestion ,less hematoma  and less end necrosis  occur, Anyway  this  type  of  dissection cause  more intra op bleeding. As we got the  good survival of  flap,we can modify  the  flap in  the  setting of  edition 11st and  12nd.

We concentrate more  on flap setting, the posterior flap is  set deeply to  the longitudinal layer of  the rectum. The anterior flap is  fixed to  the posterior bladder wall and prosthetic capsule. The labia minor is more dissected and  set  in the new style  of 3 point setting. We  separate  the midline of  anterior flap  to make  a long  midline  cleft and fix to  the prostate to  get  the  longer  and  more complete structure of labia minor. Any way  the  labia minor  end at  the  anterior  vaginal  wall  and does not  cover on  the side  of  vaginal opening.

The  penile  flap is  meticulous dissected to  make  the  very narrow pedicle  and  the narrow  clitoral  hood  can be  fixed to  the  pubic symphisis to  make  a permanent hood. The tunica albuginia get a new  design to act as  the  port of clitoral base to  make  it  stay  in midline.

The 9th is  one  of a perfect design  that  get  the concept  from  the  house  building and foundation. We set  the foundation first  to  the  strong foundation area as periostium…..the  uretral is  set first instead of  last ,then the valva , the hood  and lateral wall of labia minor was set  to the  priosteum and stump of penile  crus, Then   the pile is  complete , other structure  will  be attached  to  the pile.


With this concept  we  can control  the external appearance  of valve and it  will stay  in  midline  because the corresponse part of tissue will fix to  the proper part of bone.

Anyway,some one might need  the  more aesthetic correction of the labia to  be  longer that can be done  after 3  or 4 monthes.


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