Passerini-Glazel Feminizing Genitoplasty: Modifications in 17 Years of Experience with 82 Cases  Arianna Lesma, Aldo Bocciardi, Francesco Montorsi, Patrizio Rigatti  European Urology  Volume 52, Issue 6, Pages 1638-1644 (December 2007) DOI: 10.1016/j.eururo.2007.02.068 Copyright © 2007 European Association of Urology Terms and Conditions

Fig. 1 The line of incision described an inverted U above the anus, a vertical line up to the meatus of the urogenital sinus (UGS), a Y-shape around the UGS, and a circumferential circumcision of the hypertrophic clitoris. European Urology 2007 52, 1638-1644DOI: (10.1016/j.eururo.2007.02.068) Copyright © 2007 European Association of Urology Terms and Conditions

Fig. 2 The inferior aspect of the vaginal pouch was identified by palpation of the Fogarty catheter balloon. The anterior wall of the junction between the vagina and the urogenital sinus was incised over the balloon. European Urology 2007 52, 1638-1644DOI: (10.1016/j.eururo.2007.02.068) Copyright © 2007 European Association of Urology Terms and Conditions

Fig. 3 The vaginal catheter was retrieved through the urogenital sinus (UGS), and the posterior wall of the junction between the vagina and the UGS was divided. European Urology 2007 52, 1638-1644DOI: (10.1016/j.eururo.2007.02.068) Copyright © 2007 European Association of Urology Terms and Conditions

Fig. 4 First step of clitoroplasty: a plane of cleavage was developed between the corpora and urogenital sinus. European Urology 2007 52, 1638-1644DOI: (10.1016/j.eururo.2007.02.068) Copyright © 2007 European Association of Urology Terms and Conditions

Fig. 5 A plane of cleavage was developed between the corpora and the dorsolateral neurovascular bundles via Buck's fascia, with care taken to preserve the tunica of the corporeal body. European Urology 2007 52, 1638-1644DOI: (10.1016/j.eururo.2007.02.068) Copyright © 2007 European Association of Urology Terms and Conditions

Fig. 6 After the reduced glans was sutured to corporeal stumps, a vertical midline incision was performed on the dorsal surface of preputial and phallic skin up to the pubis. The redundant distal part of the urogenital sinus was incised dorsally. European Urology 2007 52, 1638-1644DOI: (10.1016/j.eururo.2007.02.068) Copyright © 2007 European Association of Urology Terms and Conditions

Fig. 7 The proximal skin was sutured around the glans clitoris corona. Cutaneous flaps of the hypertrophic clitoris were sutured side by side to the opened urogenital sinus so that a mucocutaneous plate was obtained. European Urology 2007 52, 1638-1644DOI: (10.1016/j.eururo.2007.02.068) Copyright © 2007 European Association of Urology Terms and Conditions

Fig. 8 The distal portion of the mucocutaneous plate was converted into a cylinder as described in Passerini-Glazel's original article. European Urology 2007 52, 1638-1644DOI: (10.1016/j.eururo.2007.02.068) Copyright © 2007 European Association of Urology Terms and Conditions

Fig. 9 The mucocutaneous cylinder and distal native vagina sutured together formed the walls of the new distal vagina. European Urology 2007 52, 1638-1644DOI: (10.1016/j.eururo.2007.02.068) Copyright © 2007 European Association of Urology Terms and Conditions

Fig. 10 The lateral labioscrotal folds can be brought down and sutured to the corners between the posterior U flap and lateral skin to form labia majora. By suturing the lateral edges of the proximal portion of the mucocutaneous plate and the labia majora's medial edges to a plane deeper than the subcutaneous tissue, it is possible to create labia minora. European Urology 2007 52, 1638-1644DOI: (10.1016/j.eururo.2007.02.068) Copyright © 2007 European Association of Urology Terms and Conditions