Metoidioplasty

Admission

You will be admitted to the hospital on the same day as the metaoidioplasty operation. During the hours prior to the surgery, the necessary monitoring will be carried out.

Preparations – Hormone treatment for a metoidioplasty

In order to achieve a micropenis through the metoidioplasty technique, it is necessary to have previously undergone androgen therapy to considerably increase clitoris size. Your endocrinologist will advise you on how and when to undergo this treatment.

Metoidioplasty technique

Metoidioplasty is a technique that uses the clitoris, previously hypertrophied through hormone treatment, to achieve a micropenis. The result is a small but sensitive, erogenous and erectile penis.

This technique is always performed under general anaesthesia and metoidioplasty surgery usually lasts between 5 and 6 hours in the operating theatre.

To construct a urethra from the base of the clitoris to the tip, the surgeon will use a flap from the anterior wall of the vagina (with an approximate length of 5 to 7.5 centimetres and a width of 2 to 3 centimetres) and a flap with the skin of the labium minora. With all this, the surgeon achieves a tubular shape to achieve the lengthening of the urethra.

During the same operation, the labia majora are mobilised dorsally and joined at the midline to form a new scrotum. Once the scrotal pouch has been created, silicone testicular implants are inserted. The implantation of the testicular prostheses can be performed during the same surgical procedure or can be postponed to a second procedure at the discretion of the surgical team performing the operation.

What is metoidioplasty?

Metoidioplasty is a gender affirmation surgery that aims to create a penis with external genitalia that allows urination while standing and satisfactory erogenous stimulation. This surgical technique allows the reconstruction of a microphallus of about 3 to 6 centimetres in length and 1.5 to 2 centimetres in diameter. This neopenis meets most functional requirements but the result does not allow sexual penetration.

Will metoidioplasty surgery allow for sexual penetration?

While metoidioplasty surgery can provide increased genital sensation and a more masculine appearance, it may not be suitable for sexual penetration. It’s important to discuss your specific goals and expectations with your surgeon to determine if metoidioplasty is the right procedure for you.

Who can undergo metoidioplasty?

While for some trans men metoidioplasty is essential, for others it is not. Before undergoing this surgery, it is essential that your medical team assesses your health and the suitability of the procedure. It is important to discuss all possible options with your surgeon.

Will I have to be hospitalised after metoidioplasty?

During metoidioplasty surgery, two drains are placed in the perineal area, which are usually removed after 24 hours. On the second post-operative day, the patient is allowed to move around. After metoidioplasty, hospitalisation usually lasts between 5 and 7 days, depending on the patient’s progress. At all times, the IM GENDER team’s aim will be to offer you and your companions a comfortable stay for a speedy recovery.

During the seven days following the metoidioplasty, it is essential to follow a residue-free diet.

Will I have postoperative visits in the postoperative period of metoidioplasty?

During the post-operative period, always follow the IM GENDER medical team’s instructions to ensure a speedy recovery. Once you are discharged from hospital, 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 the metoidioplasty.

When can I go home after metoidioplasty?

Although you will be able to go home in about 5–7 days after the metoidioplasty, you will need to continue to wear the bladder catheter for at least 21 days.

Can there be complications in the postoperative period of metaidioplasty?

The IM GENDER team will explain to the patient how to avoid possible metoidioplasty complications and, should they arise, how to proceed. Among the complications that could occur are:

• • Infection
  • You may experience an episode of bleeding during or after the procedure.
  • Extrusion of the testicular prosthesis.
  • Urethro-cutaneous fistula – communication of the urethra with the scrotal skin.
  • Urethral stricture – decrease in the urethra’s diameter.
  • Vesico-vaginal fistula – communication between the bladder and the vagina.

If you experience discomfort or simply have any doubts, you should consult the patient care team or your referring surgeon. In addition, a 24-hour phone number is available to answer any questions you may have.

What should I do if I experience pain or discomfort during the post-operative period?

If you experience pain or discomfort during the post-operative period, it’s important to follow your surgeon’s pain management plan. This may include taking prescribed medications, applying ice or heat to the surgical site, and resting as needed.

What is the recovery process like after metoidioplasty surgery?

The recovery process after metaoidioplasty surgery can vary depending on the individual and the extent of the procedure. Patients may experience pain and discomfort, swelling, and limited mobility during the initial recovery period. It is important to follow your surgeon’s postoperative care instructions carefully to promote healing and minimize the risk of complications.

What is the result after a metaoidioplasty?

After recovering from metoidioplasty, you will have a functional micropenis that is typically 3-6 cm in length, with an aesthetic appearance similar to that of a natural penis. This organ will retain erogenous sensation. However, it is important to note that metoidioplasty results may not allow for penetrative sexual intercourse.

When will I be able to have sexual activity after metoidioplasty surgery?

The timing of when you can resume sexual activity following metaoidioplasty surgery will depend on the individual and the extent of the procedure. It’s important to discuss your specific goals and expectations with your surgeon to determine when it is safe to resume sexual activity.