Anatomic and histologic changes of the penis after long-term estrogen therapy in transsexuals.

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 1998;25(7):1284-1291.
Published online October 1, 1998.

Anatomic and histologic changes of the penis after long-term estrogen therapy in transsexuals.

No authors listed

Abstract

To investigate the anatomic and histologic changes of penis as a result of long-term estrogen exposure on male, 14 penes were harvested from 14 male-to-female transsexuals who had male to female sex reassignment operation in Dong-A University Hospitall. The penils length was measured before operation and penile histologic study was done. The results were as follows : 1. Age at inception of estrogen therapy was 16-24 years. The duration of estrogen therapy was 2-12 years (mean; 6.7 years).2. The dose and method of estrogen treatment regimen were variable, but almost all patients were administrated 20 mg estradiol(Depovirin) per month for first 1 year. 3. The mean stretched penile length(SPL) was 7.9 cm. 4. The mean erectile cavernosal length(ECL) was 8.6 cm which was about 4 cm shorter than normal erectile penile length. The reduction of ECL had a tendency to be greater in proportion to the duration of estrogen exposure. 5. It was considered that the marked reduction of ECL was caused by increse of loose fibrous tissue and fatty infiltration between tunica albuginea and corpus cavernosum, which were present in most of the cases. In conclusion, it was considered that the reduction of testosterone level due to negative feedback of estrogen on hypothalamic-pituitary-gonadal axis and direct effect of estrogen on penis such as fibrosis of corpus cavernosum might produce the adverse effect on penile erection which results int reduction of ECL after long-term estrogen exposure.