Metoidioplasty results

The main functional benefit of metoidioplasty is the ability to urinate while standing, a major goal for many patients undergoing this surgery. This is achieved by extending the urethra through a graft, often using tissue from the vagina or labia. Post-surgery, most patients are able to urinate from their neopenis.

Other functional outcomes are the maintenance of erectile tissue. Though the size may be smaller than with phalloplasty, the sensitivity and erectile function provide significant physical satisfaction.

For those seeking a more complete male genital aesthetic, metoidioplasty can be performed alongside the creation of a new scrotum during the same surgical procedure. In this process, the labia majora are mobilised dorsally and joined at the midline to form a scrotal pouch. Once this pouch is established, silicone testicular implants can be inserted. The implantation of these prostheses may occur during the initial surgery or may be deferred to a subsequent procedure, depending on the surgical team’s recommendations.

One of the key advantages of metoidioplasty is the preservation of erogenous sensation. Since the surgery utilises the clitoral tissue, which has already been enlarged through testosterone therapy, the neopenis retains a high degree of sensitivity. This allows for sexual stimulation, making the organ capable of pleasurable sensations.

While penetrative intercourse is not possible due to the size of the neopenis, many patients report satisfying sexual experiences post-surgery. Sexual activity is often enhanced by the retained sensitivity, contributing to overall well-being and sexual fulfilment. The degree of sensitivity varies, but most patients maintain the ability to orgasm after surgery.

The aesthetic outcomes of metoidioplasty play an important role in a patient’s satisfaction with the surgery. Many trans men who opt for metoidioplasty do so because they are seeking a more masculine appearance in their genital area while preserving sensation. The final appearance of the neopenis is smaller compared to a phalloplasty, but it resembles male genitalia and aligns with the individual’s gender identity.

It’s important for patients to have realistic expectations regarding the size of the neopenis. Metoidioplasty is not intended to create a penis of typical cisgender size, but rather a micropenis that offers functional benefits and an aesthetic appearance that aligns with the patient’s goals.

Recovery after metoidioplasty can take several months, with final results often visible after one year. In the immediate post-operative period, patients may experience swelling, bruising, and discomfort, but these symptoms generally subside within a few weeks. Full healing of the urethral extension and the creation of the neopenis may take longer, and complications such as urethral strictures or fistulas may require additional medical attention.

During the recovery period, always follow the IM GENDER medical team’s instructions to ensure a speedy recovery. After your hospital discharge, the patient care team will schedule the follow-up medical visits and check-ups until you are officially discharged from hospital, normally one year after sex reassignment surgery.

As with any surgical procedure, metoidioplasty carries potential risks and complications. Some of the most common are:

• Urethral strictures (narrowing of the urethra)
• Urethral fistulas (an abnormal connection between the urethra and skin)
• Infection
• Extrusion of testicular implants (if inserted)

These complications, while concerning, can usually be managed with follow-up surgeries or medical interventions. It’s important to remain in close contact with your surgical team during the recovery period and attend all post-operative checkups. Patients are provided with aftercare instructions and access to a 24-hour helpline.

A common question for patients considering metoidioplasty is how the results compare to phalloplasty. While both procedures aim to create a functional penis, the outcomes differ significantly in terms of size, complexity and sexual function.

Metoidioplasty results in a smaller neopenis that is highly sensitive but does not allow for penetrative intercourse. Phalloplasty, on the other hand, creates a larger penis, often using grafts from other parts of the body, and can enable penetration when paired with a penile prosthesis. However, phalloplasty is a more complex surgery with a longer recovery time.

For trans men who prioritise sensation and are satisfied with the size limitations, metoidioplasty is often the preferred option. Those who seek a more typical male genital size and the ability to penetrate may opt for phalloplasty instead.

Beyond the physical outcomes, the psychological benefits of metoidioplasty should not be underestimated. Many trans men report a significant improvement in their mental health following the surgery, as it helps resolve gender dysphoria related to their genital appearance. The alignment of the body with gender identity can provide a sense of relief and confidence.

The emotional benefits are often closely linked to the functional and aesthetic outcomes of the surgery. Being able to urinate while standing, feeling more comfortable in intimate settings and achieving sexual pleasure all contribute to an improved quality of life.

However, it’s important to have realistic expectations and be prepared for the emotional adjustment period following surgery. Some individuals may feel immediate satisfaction, while others may need time to adjust to the changes in their body.