Title Alternative Comprehensive treatment for gender identity disorder
FullText URL 126_109.pdf
Author Namba, Yuzaburo|
Keywords 性同一性障害 包括的治療 性別適合手術
Publication Title 岡山医学会雑誌
Published Date 2014-08-01
Volume volume126
Issue issue2
Start Page 109
End Page 115
ISSN 0030-1558
language 日本語
Copyright Holders Copyright (c) 2014 岡山医学会
File Version publisher
DOI 10.4044/joma.126.109
NAID 130004685261
JaLCDOI 10.18926/AMO/52660
FullText URL 68_3_183.pdf
Author Hasegawa, Kenjiro| Namba, Yuzaburo| Kimata, Yoshihiro|
Abstract Since 2001, we have been performing phalloplasty with a radial forearm free flap as the flap of first choice in female-to-male transsexuals (FTMTS). In the present case, a 22-year-old FTMTS with a negative Allen test, we achieved good results by performing phalloplasty with an innervated island pedicled anterolateral thigh flap using the “tube within a tube” technique, in which the penis and urethra are constructed with a single flap. As compared to a forearm flap, use of an innervated islandpedicled flap may have the following advantages in phalloplasty: 1) no need for a microsurgical technique; 2) no scars at noticeable sites; 3) small functional loss in the flap donor area; 4) no sacrifice of major blood vessels. Thus, this technique seems to be a useful clinical alternative for phallic reconstruction.
Keywords gender identity disorder sex reassignment surgery (SRS) phalloplasty
Amo Type Corrected and Republished Article
Published Date 2014-06
Publication Title Acta Medica Okayama
Volume volume68
Issue issue3
Publisher Okayama University Medical School
Start Page 183
End Page 190
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2014 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 24945633
Web of Sience KeyUT 000337655600009
Related Url http://doi.org/10.18926/AMO/51869
JaLCDOI 10.18926/AMO/52013
FullText URL 67_6_391.pdf
Author Hasegawa, Kenjiro| Namba, Yuzaburo| Kimata, Yoshihiro|
Abstract Thumb polydactyly is reported to be the most common congenital anomaly of the hand in Japan. The floating type is not particularly rare, accounting for 0.9 to 15% of all cases of thumb polydactyly. However, to the best of our knowledge, there has been only one case of thumb polydactyly with a floating ulnar thumb, reported by Onizuka. Herein, we report a case very similar to that reported by Onizuka. In our case, the vessels feeding the floating ulnar thumb branched from the superficial palmar arterial arch, and X-rays revealed triphalangism. In surgery, we not only reconstructed the morphology of the thumb, but also tried to preserve the sensation in the reconstructed thumb by transposing the digital nerve of the floating ulnar thumb to the radial thumb. In addition to thumb polydactyly, our case also showed hypoplasia of the thenar muscles.
Keywords polydactyly floating ulnar thumb thumb hypoplasia
Amo Type Case Report
Published Date 2013-12
Publication Title Acta Medica Okayama
Volume volume67
Issue issue6
Publisher Okayama University Medical School
Start Page 391
End Page 395
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2013 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 24356724
Web of Sience KeyUT 000328915700008
JaLCDOI 10.18926/AMO/51869
FullText URL 67_5_325.pdf
Author Hasegawa, Kenjiro| Namba, Yuzaburo| Kimata, Yoshihiro|
Abstract Since 2001, we have been performing phalloplasty with a radial forearm free flap as the flap of first choice in female-to-male transsexuals (FTMTS). In the present case, a 22-year-old FTMTS with a negative Allen test, we achieved good results by performing phalloplasty with an innervated island pedicled anterolateral thigh flap using the "tube within a tube" technique, in which the penis and urethra are constructed with a single flap. While phalloplasty with an island-pedicled or free anterolateral thigh flap has been reported previously, the present case seems to be the first of phalloplasty with an innervated island-pedicled anterolateral thigh flap using the "tube within a tube" technique. As compared to a forearm flap, use of an innervated island-pedicled flap may have the following advantages in phalloplasty:1) no need for a microsurgical technique;2) no scars at noticeable sites;3) small functional loss in the flap donor area;4) no sacrifice of major blood vessels. Thus, this technique seems to be a useful clinical alternative for phallic reconstruction.
Keywords gender identity disorder sex reassignment surgery (SRS) phalloplasty
Amo Type Case Report
Published Date 2013-10
Publication Title Acta Medica Okayama
Volume volume67
Issue issue5
Publisher Okayama University Medical School
Start Page 325
End Page 331
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2013 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 24145733
Web of Sience KeyUT 000325836100007
Related Url http://doi.org/10.18926/AMO/52660
JaLCDOI 10.18926/AMO/51073
FullText URL 67_4_271.pdf
Author Hasegawa, Kenjiro| Namba, Yuzaburo| Kimata, Yoshihiro|
Abstract In the postoperative treatment of hand surgery, it is important to start exercise therapy as early as possible. In conventional negative pressure wound therapy, the fingers are immobilized by the film dressing covering the wound and hand, thereby preventing sufficient rehabilitation. Here, we devised a bag-type negative pressure wound therapy that makes it possible to start finger exercises almost immediately, and we applied it to 4 patients:one each with hand burns, symmetrical peripheral gangrene, a crush injury accompanied by extensive skin defects and a fingertip degloving injury. The duration of the bag-type negative pressure wound therapy ranged from three to eight weeks, and good granulation was achieved, so that a skin graft was not required. In addition, particularly in the case of the fingertip degloving injury, good nail regeneration was achieved. Except for the case of symmetrical peripheral gangrene, a good range of joint motion with a percent total active motion (%TAM) of 94.7% or more was achieved. Our therapy was performed by inserting the hand into a sealing bag;sufficient exercise therapy was made possible by expanding the bag during rehabilitation.
Keywords negative pressure wound therapy early exercise therapy wound healing hand surgery
Amo Type Case Report
Published Date 2013-08
Publication Title Acta Medica Okayama
Volume volume67
Issue issue4
Publisher Okayama University Medical School
Start Page 271
End Page 276
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
Copyright Holders CopyrightⒸ 2013 by Okayama University Medical School
File Version publisher
Refereed True
PubMed ID 23970327
Web of Sience KeyUT 000323470100010
JaLCDOI 10.18926/AMO/32875
FullText URL fulltext.pdf
Author Namba, Yuzaburo| Sugiyama, Narushi| Yamashita, Shuji| Hasegawa, Kenjiro| Kimata, Yoshihiro| Ishii, Kazushi| Nasu, Yasutomo|
Abstract <p>To date, many techniques have been reported for vaginoplasty in male-to-female trans-sexual (MTFTS) patients, such as the use of a rectum transfer, a penile-scrotal flap and a reversed penile flap. However, none of these procedures is without its disadvantages. We developed a newly kind of flap for vaginoplasty, the M-shaped perineo-scrotal flap (M-shaped flap), using skin from both sides of the scrotum, shorn of hair by preoperative laser treatment. We applied this new type of flap in 7 MTFTS patients between January 2006 and January 2007. None of the flaps developed necrosis, and the patients could engage in sexual activity within 3 months of the operation. The M-shaped flap has numerous advantages: it can be elevated safely while retaining good vascularity, it provides for the construction of a sufficient deep vagina without a skin graft, the size of the flap is not influenced entirely by the length of the penis, and it utilizes skin from both sides of the scrotal area, which is usually excised.</p>
Keywords vaginoplasty male-to-female transsexual perineo-scrotal flap
Amo Type Original Article
Published Date 2007-12
Publication Title Acta Medica Okayama
Volume volume61
Issue issue6
Publisher Okayama University Medical School
Start Page 355
End Page 360
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 18183081
Web of Sience KeyUT 000251943800007
JaLCDOI 10.18926/AMO/31841
FullText URL fulltext.pdf
Author Namba, Yuzaburo| Watanabe, Toshiyuki| Kimata, Yoshihiro|
Abstract <p>The first operative procedure in sex reassignment surgery (SRS) for female-to-male transsexuals (FTMTS) is mastectomy. This procedure includes the removal of mammary tissue, removal of excess skin, and reduction and proper repositioning of the nipple and areola complex. We have performed mastectomies in over 120 patients since January 2001 and want to describe the operative procedures we have developed. We classified our patients into 3 groups according to the patient's breast volume and the degree of ptosis, and we selected the operative procedure that was suitable for each group. At present all costs for SRS are assumed by the patient in Japan. If the FTMTS patient undergoes the entire series of SRS operations, he has to pay more than 3,000,000 yen. Thus the surgeon should select the proper operative procedure so that the patient can avoid unnecessary additional operations. We describe herein the techniques and the strategy for performing mastectomy in FTMTS.</p>
Keywords mastectomy female-to-male transsexual sex reassignment surgery
Amo Type Original Article
Published Date 2009-10
Publication Title Acta Medica Okayama
Volume volume63
Issue issue5
Publisher Okayama University Medical School
Start Page 243
End Page 247
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 19893600
Web of Sience KeyUT 000271132000004
JaLCDOI 10.18926/AMO/30981
FullText URL fulltext.pdf
Author Namba, Yuzaburo| Sugiyama, Narushi| Yamashita, Shuji| Tokuyama, Eijiro| Hasegawa, Kenjiro| Kimata, Yoshihiro|
Abstract <p>Between January 2001 and December 2007, we performed vaginoplasty as sex reassignment surgery in a total of 14 male-to-female transsexual (MTFTS) patients [1]. Several complications occurred such as partial flap necrosis, rectovaginal fistula formation and hypersensitivity of the neoclitoris. Just after the operation, some patients feel that their penises still exist, but by several weeks postoperatively, this sensation has disappeared. Herein we report a case of MTFTS in whom the sensation of a phantom erectile penis persisted for much longer.</p>
Keywords gender identity disorder sex reassignment surgery phantom erectile penis
Amo Type Case Report
Published Date 2008-06
Publication Title Acta Medica Okayama
Volume volume62
Issue issue3
Publisher Okayama University Medical School
Start Page 213
End Page 216
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 18596839
Web of Sience KeyUT 000257130300010
JaLCDOI 10.18926/AMO/30948
FullText URL fulltext.pdf
Author Namba, Yuzaburo| Sugiyama, Narushi| Yamashita, Shuji| Hasegawa, Kenjiro| Kimata, Yoshihiro| Nakatsuka, Mikiya|
Abstract <p>We treated 2 different types of intersexual patients who underwent a vaginoplasty with the pudendal-thigh flap. One was a female with testicular feminization syndrome for whom we reconstructed the total vagina with a pudendal-thigh flap, and the other was a female with an adrenogenital syndrome for whom we enlarged the introitus of the vagina with the same approach. There were no complications such as a flap necrosis. In addition, there was no stricture of the neo-vagina and no urinary problem.</p>
Keywords vaginoplasty intersexual pudendal-thigh flap
Amo Type Case Report
Published Date 2008-12
Publication Title Acta Medica Okayama
Volume volume62
Issue issue6
Publisher Okayama University Medical School
Start Page 415
End Page 419
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
Web of Sience KeyUT 000262025000009
JaLCDOI 10.18926/AMO/30718
FullText URL fulltext.pdf
Author Namba, Yuzaburo| Kimata, Yoshihiro| Koshima, Isao| Sugihara, Shinsuke| Sato, Tohru|
Abstract We treated a case with left tibial adamantinoma by use of a contralateral fibular osteoadiposal flap. The donor site of conventional fibular osteocutaneous flap must be covered with a skin graft because if we close the donor skin defect directly, compartment syndrome might occur. We were able to close the donor skin defect because this combined type flap included only a small monitoring skin paddle. We present herein the utility of the osteoadiposal flap and show the value of a skin-sparing approach with a minimal aesthetic defect.
Keywords adamantinoma fibular osteoadiposal flap skin-sparing flap harvest
Amo Type Article
Published Date 2006-08
Publication Title Acta Medica Okayama
Volume volume60
Issue issue4
Publisher Okayama University Medical School
Start Page 233
End Page 236
ISSN 0386-300X
NCID AA00508441
Content Type Journal Article
language 英語
File Version publisher
Refereed True
PubMed ID 16943861
Web of Sience KeyUT 000239911100005
Author Takahashi, Yoshio| Namba, Yuuzaburou| Kishimoto, Kouji| Koshima, Isao|
Published Date 2001-12-31
Publication Title 岡山医学会雑誌
Volume volume113
Issue issue3
Content Type Journal Article
Author 難波 祐三郎|
Published Date 2000-03-25
Publication Title
Content Type Thesis or Dissertation