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Overview on metoidioplasty: variants of the technique

International Journal of Impotence Research volume 33, pages 762–770 (2021)Cite this article

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Abstract

Number of gender dysphoric people increased over the last few decades with positive social acceptance of transpopulation. Genital gender affirming surgeries are of utmost importance in order to adjust body to the mind of these individuals. Creation of the phallus is usually the last step in transmen transition, which remains demanding and challenging for surgeons, with different options for phalloplasty available. The ideal phallus is esthetically appealing, with preserved tactile and erogenous sensation, enables standing micturition and sexual function with minimal donor-site morbidity. Metoidioplasty, as a variant of phalloplasty, uses the hormonally hypertrophied clitoris to create the neophallus. Metoidioplasty can be considered as a method of choice for thin-built individuals looking for male genitalia with preserved erogeneity, in one-stage genital gender affirming surgery. It can be combined together with removal of reproductive organs and vaginectomy. Preoperative consultation with patients and postoperative follow-up as well as multidisciplinary approach are essential for successful treatment.This literature review aims to assess and discuss different metoidioplasty approaches with a special reference to authors’ current metoidioplasty technique.

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Fig. 1: Preoperative appearance of hormonally hypertrophied clitoris.
Fig. 2: Clitoral lenghtening and straightening.
Fig. 3: Urethral reconstruction.
Fig. 4: A neourethra is created from labia minora flap and buccal mucosa graft.
Fig. 5: Neophallic skin reconstruction using available genital skin is performed. Perineum is created to be male-like.
Fig. 6: Outcome 4 weeks after the surgery.

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Acknowledgements

This study is supported by Ministry of Education, Science and Technological Development, Republic of Serbia, Project No. 175048.

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Authors and Affiliations

  1. Department of Urology, University Children’s Hospital, Faculty of Medicine, University of Belgrade, Belgrade, Serbia

    Marta Bizic, Borko Stojanovic, Marko Bencic & Miroslav Djordjevic

  2. Belgrade Center for Urogenital Reconstructive Surgery, Belgrade, Serbia

    Marta Bizic, Borko Stojanovic, Marko Bencic, Noémi Bordás & Miroslav Djordjevic

  3. Department of Urology, Kiskunhalasi Semmelweis Kórház, Kiskunhalas, Hungary

    Noémi Bordás

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  1. Marta Bizic
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Correspondence to Marta Bizic.

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Bizic, M., Stojanovic, B., Bencic, M. et al. Overview on metoidioplasty: variants of the technique. Int J Impot Res 33, 762–770 (2021). https://doi.org/10.1038/s41443-020-00346-y

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