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This is also known as a free flap phalloplasty. The forearm skin is grafted along with its nerves, arteries, and veins and formed around a plastic catheter tube, which will serve as the urethra and allow for urination once connected to the female urethra. The forearm skin is used to create the shaft, glans (head), and urethra. The nerves of the clitoris are attached to the grafted nerves and will grow into the penis after surgery. The skin and tissue of the vaginal labia is used to create a scrotum.