The 12th edition
In some patient that have long penis we will try to use the penile flap to be the anterior vaginal wall. To avoid the graft contractionb at the anterior vaginal wall and to gain the benefit of flap elasticity, the new design of penile flap has been deveioped. It take about 1 year to get this setting prior to failure of other 2 setting. The anterior penile flap is separate to make the long labia minor and the distal end turn to construct the vaginal wall next to the urethral opening. In this setting the urethal opening is quite stable and the vaginal opening is wider and more elastig. So the dilation and sexual intercourse will be much easier.
The 2nd version of the 12nd edition
As we set the urethal flap and graft in the new design, we modify the technique of tissure setting. We interpose the urethal opening and the distal penile flap with the urethal graft. Therefore the opening of valva consist of mucosal tissue that have slippery surface which facilitate the dilation and insertion