Metoidioplasty

Bizic, M.; Stojanovic, Borko; Joksić, Ivana; Djordjević, Miroslav L.

doi:10.1016/j.ucl.2019.07.009

Cited by 27 publications

(26 citation statements)

References 24 publications

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“…Due to the presence of androgen receptors, the clitoris enlarges under testosterone therapy, so that one part of the clitoral body becomes visible as well. As reported by several different studies, the preoperative clitoral size in transmen varies from 2.5 to 4.6 cm [5,15,16] . Its dissection and the division of suspensory ligaments during metoidioplasty will allow for straightening and additional lengthening of the clitoris and enable voiding while standing.…”

Section: Preoperative Evaluationmentioning

confidence: 78%

“…Transmale individuals undergoing genital reconstruction in GAS are required to have spent at least one year on hormonal substitution therapy according to the WPATH SOC [1] . For those who have chosen metoidioplsty as the surgical technique, additional preoperative short-term use of vacuum pump in combination with local application of dihydrotestosterone gel is recommended to provide better postoperative results [5,12] .…”

Section: Preoperative Evaluationmentioning

confidence: 99%

“…The first phalloplasty was performed in the 1930s by Bogoras, followed by years of refining surgical techniques to satisfy patients' expectations of functionality and esthetics. However, there is no replacement for erectile, urethral tissue, and nerves that would provide ideal male genitals for males requiring genital reconstruction [5,6] . The reconstruction of the neophallus should be performed as a onestage procedure, yielding sensation (tactile and erogenous), functional neourethra (ability of stand-up voiding), penetrative sexual intercourse, and minimal scarring of the donor site [5,7] .…”

Section: Introductionmentioning

confidence: 99%

“…However, there is no replacement for erectile, urethral tissue, and nerves that would provide ideal male genitals for males requiring genital reconstruction [5,6] . The reconstruction of the neophallus should be performed as a onestage procedure, yielding sensation (tactile and erogenous), functional neourethra (ability of stand-up voiding), penetrative sexual intercourse, and minimal scarring of the donor site [5,7] . Unfortunately, to this day, there is no single surgical technique to satisfy all these goals of male genitalia reconstruction [8] .…”

Section: Introductionmentioning

confidence: 99%

“…Metoidioplasty involves creation of the neophallus using the hormonally-hypertophied clitoris, with or without urethroplasty, and scrotoplasty, with or without testicular prostheses implantation. In the majority of patients, metoidioplasty enables voiding in standing position and full erogenous sensation, but penetration during sexual intercourse is possible in only rare cases (by self-report) [5,9] . The first report of using clitoris in male genitalia reconstruction was in 1973, and as a term "metoidioplasty" was first introduced by Lebovic and Laub, originally from the Greek words "meta" (change), "aidion" (female genitalia), and "plasty" (formation) [10,11] .…”

Section: Introductionmentioning

confidence: 99%

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Metoidioplasty as a one-stage phallic reconstruction in transmen

Bizic¹,

Stojanovic²,

Bencic³

et al. 2020

Plast Aesthet Res

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Gender dysphoria is a condition where there is a discrepancy between the gender assigned at birth and the desired gender, leading the patient to pursue surgical intervention. Reconstruction of the neophallus for transmen is still challenging, even though there are many surgical techniques with satisfying results. The aim of neophallic reconstruction in gender affirmation surgery (GAS) for transmen is to provide stand-up voiding, erotic sensation, orgasm and penetration ability, and acceptable donor site morbidity with minimal scarring and complications. Metoidioplasty as a variant of phalloplasty for transmen is a one-stage procedure that results in male-like external genitals, with minimal scarring, ability of standing micturition, and full erogenous sensation with the ability to achieve orgasm during sexual intercourse. Metoidioplasty is a method of choice for those transmen who wish to have GAS in one procedure without multi-staged procedures to create the adult-male-sized neophallus.

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Section: Preoperative Evaluationmentioning

confidence: 78%

Section: Preoperative Evaluationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Metoidioplasty as a one-stage phallic reconstruction in transmen

Bizic¹,

Stojanovic²,

Bencic³

et al. 2020

Plast Aesthet Res

Self Cite

View full text Add to dashboard Cite

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Updates on metoidioplasty

Stojanovic

Djordjević

2022

Neurourology and Urodynamics

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Aims Metoidioplasty presents a variant of phalloplasty in transmen who require simple and safe genital gender affirmation surgery (GAS). The aim is to evaluate updates on the technique, as well as personal experience. Methods The surgical steps of metoidioplasty are removal of the vagina, clitoral straightening and lengthening, urethral lengthening using available flaps and grafts, and creation of the scrotum with testicular prostheses implantation. The surgical goal is to achieve appearance of male genitalia, voiding in standing position, and full erogenous sensitivity. Modifications of the technique have developed due to recent advances in anatomy and new requests from transmen. Besides full metoidioplasty, other variants include metoidioplasty before, after or simultaneously with total phalloplasty. Each variant has its' own advantages, which must be discussed with the candidate preoperatively. Results A total of 938 transmen with the mean age of 29 years underwent one‐stage metoidioplasty between January 2004 and January 2022. In majority of cases (65%) metoidioplasty was performed as a final option, and the length of the neophallus ranged between 4 and 10 cm. Urethral complications occurred in 143 cases, dislocation and rejection of testicular implant in 55 and vaginal remnant in 92 cases. Voiding in standing position was reported in almost all cases (99%), and 12.5% of transmen requested phalloplasty after metoidioplasty. Conclusion Metoidioplasty is a safe, one‐stage procedure with good esthetic and functional outcomes. It includes a wide spectrum of variants that can be offered to transmen as a part of genital reconstruction, with goal of achieving patients' satisfaction.

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