Metoidioplasty

What is metoidioplasty?

Metoidioplasty is genital gender confirmation surgery (GGCS) whose goal is to create a neophallus with external genitalia in accordance with their gender that enables urination while standing up and satisfactory erogenous stimulation.

This surgical technique enables the reconstruction of a microphallus around three to six centimetres long and 1.5 to two centimetres in diameter. This neophallus fulfils most functional requirements yet the result does not allow sexual penetration.

The preparations

To attain a microphallus using the metoidioplasty technique it is necessary to have previously undergone an androgenic treatment to increase the size of the clitoris considerably. Your surgeon will advise you how and when to begin this treatment.

Admission

The patient will be admitted to the hospital centre on the same day as the operation. In the preceding hours, pertinent controls will be conducted and the patient will remain hospitalised for about five days before being discharged.

The operation

Metoidioplasty is a technique that uses the clitoris – previously hypertrophied through hormone treatment – to construct a microphallus. The result is a small yet sensitive, erogenous, erectile phallus.

This technique is always performed under general anaesthesia and tends to last from five to six hours.

To construct a urethra from the base to the head of the clitoris, the surgeon will use a graft from the anterior wall of the vagina (with an approximate length of five to 7.5 centimetres and a girth of two to three centimetres) and a flap using the skin of the labia minora.

Through this, the surgeon attains a tubular shape to achieve the lengthening of the urethra.

During the same operation, the labia majora are dorsally mobilised and joined on the centre axis to form a neoscrotum. Once the scrotal pouch has been created, silicone testicular implants are inserted. Implantation of the testicular prosthesis may be undertaken during the same surgical operation or postponed for a second operation depending on surgical criteria.

Recovery

After the first 48 hours, the patient may be moved.

Despite being discharged five to six days after the operation, the patient must use a urinary catheter for at least 21 days.

Possible complications

The complications that may most frequently appear are:

  • Infection
  • Bleeding: The patient may experience an episode of bleeding during or after the operation.
  • Extrusion of the testicular prosthesis.
  • Urethrocutaneous fistula: an opening between the urethra and the scrotal skin.
  • Urethral stenosis: a narrowing of the diameter of the urethra.
  • Vesicovaginal fistula: an opening between the bladder and the vagina