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Description of the Baudet Surgical Technique and Introduction of a Systematic Method for Training Surgeons to Perform Male-to-Female Sex Reassignment Surgery



Male-to-female sex reassignment surgery involves three main procedures, namely, clitoroplasty, new urethral meatoplasty and vaginopoiesis. Herein we describe the key steps of our surgical technique.


Male-to-female sex reassignment surgery includes the following 14 key steps which are documented in this article: (1) patient installation and draping, (2) urethral catheter placement, (3) scrotal incision and vaginal cavity formation, (4) bilateral orchidectomy, (5) penile skin inversion, (6) dismembering of the urethra from the corpora, (7) neoclitoris formation, (8) neoclitoris refinement, (9) neovaginalphallic cylinder formation, (10) fixation of the neoclitoris, (11) neovaginalphallic cylinder insertion, (12) contouring of the labia majora and positioning the neoclitoris and urethra, (13) tie-over dressing and (14) compression dressing.


The size and position of the neoclitoris, position of the urethra, adequacy of the neovaginal cavity, position and tension on the triangular flap, size of the neo labia minora, size of the labia majora, symmetry and ease of intromission are important factors when considering the immediate results of the surgery. We present our learning process of graduated responsibility for optimisation of these results. We describe our postoperative care and the possible complications.


Herein, we have described the 14 steps of the Baudet technique for male-to-female sex reassignment surgery which include clitoroplasty, new urethral meatoplasty and vaginopoiesis. The review of each key stage of the procedure represents the first step of our global teaching process.

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  1. Hoyer N, Steining HJ, Haire N (1933) Man into woman. EP Dutton & Co, New York

    Google Scholar 

  2. Laub DR, Gandy P (eds) (1973) Proceedings of the second interdisciplinary symposium on gender dysphoria syndrome. Stanford University Medical Center, Division of Reconstructive and Rehabilitation Surgery, Stanford

  3. Hage JJ (1999) Vaginoplasty in male-to-female transsexuals by inversion of penile and scrotal skin. In: Ehrlich RM, Alter GJ (eds) Reconstructive and plastic surgery of the external genitalia, adult and pediatric. WB Saunders, Philadelphia, pp 294–300

    Google Scholar 

  4. Bowers M (2009) 5-year experience with one-stage vaginoplasty: results and techniques. Paper presented at the biannual meeting of world professional association for transgender health Oslo, Norway, 18 June 2009

  5. Perovic SV, Stanojevic DS, Djordjevic ML (2000) Vaginoplasty in male transsexuals using penile skin and a urethral flap. BJU Int 86:843–850

    CAS  Article  PubMed  Google Scholar 

  6. Selvaggi G, Ceulemans P, De Cuypere G et al (2005) Gender identity disorder: general overview and surgical treatment for vaginoplasty in male-to-female transsexuals. Plast Reconstr Surg 116:135e–145e

    Article  PubMed  Google Scholar 

  7. Watanyusakul S (2004) The results of sensated clitoris and labia minora reconstruction using dorsal neurovascular glans penis preputial island flap (Chonburi flap) in MTF reassignment surgery. Paper presented at the 9th oriental society of aesthetic plastic surgery (OSAPS). The Shangri-La Hotel, Bangkok, 6–10 Dec 2004

  8. Wangjiraniran B, Selvaggi G, Chokrungvaranont P, Jindarak S, Khobunsongserm S, Tiewtranon P (2014) Male-to-female vaginoplasty: Preecha’s surgical technique. J Plast Surg Hand Surg 30:1–7

    Google Scholar 

  9. Leclère FM, Casoli V, Weigert R (2015) Outcome of vaginoplasty in male-to-female transgenders: a systematic review of surgical techniques. J Sex Med 12:1655–1656

    Article  PubMed  Google Scholar 

  10. O’Connell HE, Hutson JM, Anderson CR, Plenter RJ (1998) Anatomical relationship between urethra and clitoris. J Urol 159:1892–1897

    Article  PubMed  Google Scholar 

  11. O’Connell HE, Sanjeevan KV, Hutson JM (2005) Anatomy of the clitoris. J Urol 174:1189–1195

    Article  PubMed  Google Scholar 

  12. Selvaggi G, Monstrey S, Ceulemans P et al (2007) Genital sensitivity after sex reassignment surgery. Ann Plast Surg 58:427–433

    CAS  Article  PubMed  Google Scholar 

  13. Selvaggi G, Bellringer J (2011) Gender reassignment surgery: an overview. Nat Rev Urol 8:274–282

    Article  PubMed  Google Scholar 

  14. Worblewski P, Gustafsson J, Selvaggi G (2013) Sex reassignment surgery for transsexuals. Curr Opin Endocrinol Diabetes Obes 20:570–574

    Article  Google Scholar 

  15. Sutcliffe PA, Dixon S, Akehurst RL et al (2009) Evaluation of surgical procedures for sex reassignment : a systematic review. J Plast Reconstr Aesthet Surg 62:294–306

    CAS  Article  PubMed  Google Scholar 

  16. Sarrau M, Casoli V, Weigert R (2014) Successful conservative management of traumatic post-coital recto-neovaginal fistula in male-to-female transsexual. J Obstet Gynaecol 34:747–748

    CAS  Article  PubMed  Google Scholar 

  17. Wright TP (1936) Factors affecting the cost of airplanes. J Aeronaut Sci 3:122–128

    Article  Google Scholar 

  18. Reynolds T, Kong ML (2010) Shifting the learning curve. BMJ 341:c6260

    Article  PubMed  Google Scholar 

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Correspondence to Franck Marie Leclère.

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Leclère, F.M., Casoli, V., Baudet, J. et al. Description of the Baudet Surgical Technique and Introduction of a Systematic Method for Training Surgeons to Perform Male-to-Female Sex Reassignment Surgery. Aesth Plast Surg 39, 927–934 (2015).

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  • Vaginoplasty
  • Vaginopoiesis
  • Male-to-female transsexual
  • Learning curve
  • Transsexualism
  • Sex reassignment surgery