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Metoidioplasty

April 11, 2024

Metoidioplasty, metaoidioplasty, or metaidoioplasty[2] (informally called a meto or meta) is a female-to-male gender-affirming surgery.[3]

Example of completed metoidioplasty including neourethra and scrotoplasty, two years post-operation[1]

Testosterone replacement therapy gradually enlarges the clitoris to a mean maximum size of 4.6 cm (1.8 in)[4] (as the clitoris and the penis are developmentally homologous). In a metoidioplasty, the urethral plate and urethra are completely dissected from the clitoral corporeal bodies, then divided at the distal (far) end, and the testosterone-enlarged clitoris straightened out and elongated. A longitudinal vascularized island flap is configured and harvested from the dorsal skin of the clitoris, reversed to the ventral side, tubularized and an anastomosis (connection) is formed with the native urethra. The new urethral meatus is placed along the neophallus (newly formed penis) to the distal end and the skin of the neophallus and scrotum reconstructed using labia minora and majora flaps.[5] The new neophallus ranges in size from 4–10 cm (1.6–3.9 in) (with an average of 5.7 cm (2.2 in)) and has the approximate girth of a human adult thumb.[6]

The term derives from meta- "change", Ancient Greek αἰδοῖον, aidoion, 'genitals', and -plasty, denoting surgical construction or modification.[2]

Operation edit

 
Metoidioplasty procedure (via 'Belgrade technique'). A) Preoperative appearance (hormonally enlarged clitoris). B) Cutting of ligaments that suspend the clitoris to elongate it. C) Division of urethral plate with gap filled with vaginal mucosa graft D) Combining the vascularized labial tissue with the formed urethra to form final structure.

Alternative techniques edit

Recent studies have introduced an operative technique known as extensive metoidioplasty. This method extensively detaches the clitoris, nearly completely detaching it from the pubic arch before its reattachment and elongation. Current studies show this method yielding penile lengths of 6–12 centimeters, with 7/10 patients being capable of obtaining erections capable of penetrative intercourse.[7]

Complications edit

Complications from metoidioplasty vary in severity. Minor complications may be resolved through minor supportive care, while more serious complications may require surgical correction. As with other surgical procedures, metoidioplasty has the possibility to cause infection, bleeding, blood clots, damage to surrounding tissues, pain, as well as negative reactions to anesthesia or other required medications.

If urethral lengthening is performed, urethral complications such as urinary fistula may occur.[8] Patients who experience postvoid incontinence or dribbling following surgery report their symptoms as resolved within three months.[9]

Satisfaction rates among patients who undergo metoidioplasty are generally very high regarding both appearance and sexual satisfaction.[9][10]

Comparison with phalloplasty edit

Metoidioplasty is technically simpler than phalloplasty, more affordable, and has fewer potential complications. However, phalloplasty patients are far more likely to be capable of sexual penetration (mainly due to size constraints) after they recover from surgery.[11]

In a phalloplasty, a plastic surgeon fabricates a neopenis by autografting tissue from a donor site (such as from the patient's back, arm or leg). A phalloplasty takes about 8–10 hours to complete (the first stage), and is generally followed by multiple (up to three) additional surgical procedures including glansplasty, scrotoplasty, testicular prosthesis, and/or penile implantation.

Metoidioplasty typically requires 2–3 hours to complete. Because the clitoris' erectile tissue functions normally, a prosthesis is unnecessary for erection (although the clitoris might not become as rigid as a penile erection). In nearly all cases, metoidioplasty patients can continue to have clitoral orgasms after surgery.

Note also, that the two alternative techniques are not mutually exclusive and phalloplasty extension of a metioidiplasic base neophallus is possible.[12]

History edit

The first metoidioplasty was reported in 1973 and the term was coined in a 1989 paper.[13][14]

See also edit

References edit

  1. ^ Bordas N, Stojanovic B, Bizic M, Szanto A, Djordjevic ML (2021-10-13). "Metoidioplasty: Surgical Options and Outcomes in 813 Cases". Frontiers in Endocrinology. 12: 760284. doi:10.3389/fendo.2021.760284. PMC 8548780. PMID 34721306.
  2. ^ a b Hage JJ (January 1996). "Metaidoioplasty: an alternative phalloplasty technique in transsexuals". Plastic and Reconstructive Surgery. 97 (1): 161–167. doi:10.1097/00006534-199601000-00026. PMID 8532774. S2CID 38412526.
  3. ^ Perovic SV, Djordjevic ML (December 2003). "Metoidioplasty: a variant of phalloplasty in female transsexuals". BJU International. 92 (9): 981–5. doi:10.1111/j.1464-410x.2003.04524.x. PMID 14632860. S2CID 11836091.
  4. ^ Meyer WJ, Webb A, Stuart CA, Finkelstein JW, Lawrence B, Walker PA (April 1986). "Physical and hormonal evaluation of transsexual patients: a longitudinal study". Archives of Sexual Behavior. 15 (2): 121–38. doi:10.1007/BF01542220. PMID 3013122. S2CID 42786642.
  5. ^ Perovic, S. and Djordjevic, M. (2003), Metoidioplasty: a variant of phalloplasty in female transsexuals. BJU International, 92: 981-985. doi:10.1111/j.1464-410X.2003.04524.x
  6. ^ Djordjevic ML, Stanojevic D, Bizic M, Kojovic V, Majstorovic M, Vujovic S, Milosevic A, Korac G, Perovic SV (May 2009). "Metoidioplasty as a single stage sex reassignment surgery in female transsexuals: Belgrade experience". The Journal of Sexual Medicine. 6 (5): 1306–13. doi:10.1111/j.1743-6109.2008.01065.x. PMID 19175859.
  7. ^ Cohanzad S (February 2016). "Extensive Metoidioplasty as a Technique Capable of Creating a Compatible Analogue to a Natural Penis in Female Transsexuals". Aesthetic Plastic Surgery. 40 (1): 130–8. doi:10.1007/s00266-015-0607-4. PMID 26744289. S2CID 40551674.
  8. ^ "Metoidioplasty Risks and Complications: Is Metoidioplasty Really Worth It?". Trans Media Network.
  9. ^ a b Vukadinovic V, Stojanovic B, Majstorovic M, Milosevic A (2014). "The role of clitoral anatomy in female to male sex reassignment surgery". TheScientificWorldJournal. 2014: 437378. doi:10.1155/2014/437378. PMC 4005052. PMID 24982953.
  10. ^ De Cuypere G, TSjoen G, Beerten R, Selvaggi G, De Sutter P, Hoebeke P, et al. (December 2005). "Sexual and physical health after sex reassignment surgery". Archives of Sexual Behavior. 34 (6): 679–90. doi:10.1007/s10508-005-7926-5. PMID 16362252. S2CID 42916543.
  11. ^ Frey JD, Poudrier G, Chiodo MV, Hazen A (December 2016). "A Systematic Review of Metoidioplasty and Radial Forearm Flap Phalloplasty in Female-to-male Transgender Genital Reconstruction: Is the "Ideal" Neophallus an Achievable Goal?". Plastic and Reconstructive Surgery. Global Open. 4 (12): e1131. doi:10.1097/GOX.0000000000001131. PMC 5222645. PMID 28293500.
  12. ^ Al-Tamimi M, Pigot GL, van der Sluis WB, van de Grift TC, van Moorselaar RJ, Mullender MG, et al. (November 2019). "The Surgical Techniques and Outcomes of Secondary Phalloplasty After Metoidioplasty in Transgender Men: An International, Multi-Center Case Series". The Journal of Sexual Medicine. 16 (11): 1849–1859. doi:10.1016/j.jsxm.2019.07.027. PMID 31542350. S2CID 202731384.
  13. ^ Bordas, Noemi; Stojanovic, Borko; Bizic, Marta; Szanto, Arpad; Djordjevic, Miroslav L. (2021). "Metoidioplasty: Surgical Options and Outcomes in 813 Cases". Frontiers in Endocrinology. 12: 760284. doi:10.3389/fendo.2021.760284. PMC 8548780. PMID 34721306.
  14. ^ Hage, Joris J. (1996). "Metaidoioplasty: An Alternative Phalloplasty Technique in Transsexuals". Plastic and Reconstructive Surgery. 97 (1): 161–167. doi:10.1097/00006534-199601000-00026. PMID 8532774. S2CID 38412526.

Further reading edit

  • Greenwald D, Stadelmann W (July 2001). "Gender reassignment". EMedicine Journal. 2 (7).

External links edit

  •   Media related to Metoidioplasty at Wikimedia Commons
  • Metoidioplasty.net - The Metoidioplasty Surgery Guide

April 11, 2024
metoidioplasty, this, article, needs, additional, citations, verification, please, help, improve, this, article, adding, citations, reliable, sources, unsourced, material, challenged, removed, find, sources, news, newspapers, books, scholar, jstor, april, 2010. This article needs additional citations for verification Please help improve this article by adding citations to reliable sources Unsourced material may be challenged and removed Find sources Metoidioplasty news newspapers books scholar JSTOR April 2010 Learn how and when to remove this template message Metoidioplasty metaoidioplasty or metaidoioplasty 2 informally called a meto or meta is a female to male gender affirming surgery 3 Example of completed metoidioplasty including neourethra and scrotoplasty two years post operation 1 Testosterone replacement therapy gradually enlarges the clitoris to a mean maximum size of 4 6 cm 1 8 in 4 as the clitoris and the penis are developmentally homologous In a metoidioplasty the urethral plate and urethra are completely dissected from the clitoral corporeal bodies then divided at the distal far end and the testosterone enlarged clitoris straightened out and elongated A longitudinal vascularized island flap is configured and harvested from the dorsal skin of the clitoris reversed to the ventral side tubularized and an anastomosis connection is formed with the native urethra The new urethral meatus is placed along the neophallus newly formed penis to the distal end and the skin of the neophallus and scrotum reconstructed using labia minora and majora flaps 5 The new neophallus ranges in size from 4 10 cm 1 6 3 9 in with an average of 5 7 cm 2 2 in and has the approximate girth of a human adult thumb 6 The term derives from meta change Ancient Greek aἰdoῖon aidoion genitals and plasty denoting surgical construction or modification 2 Contents 1 Operation 1 1 Alternative techniques 2 Complications 3 Comparison with phalloplasty 4 History 5 See also 6 References 7 Further reading 8 External linksOperation edit nbsp Metoidioplasty procedure via Belgrade technique A Preoperative appearance hormonally enlarged clitoris B Cutting of ligaments that suspend the clitoris to elongate it C Division of urethral plate with gap filled with vaginal mucosa graft D Combining the vascularized labial tissue with the formed urethra to form final structure This section needs expansion You can help by adding to it December 2022 Alternative techniques edit Recent studies have introduced an operative technique known as extensive metoidioplasty This method extensively detaches the clitoris nearly completely detaching it from the pubic arch before its reattachment and elongation Current studies show this method yielding penile lengths of 6 12 centimeters with 7 10 patients being capable of obtaining erections capable of penetrative intercourse 7 Complications editComplications from metoidioplasty vary in severity Minor complications may be resolved through minor supportive care while more serious complications may require surgical correction As with other surgical procedures metoidioplasty has the possibility to cause infection bleeding blood clots damage to surrounding tissues pain as well as negative reactions to anesthesia or other required medications If urethral lengthening is performed urethral complications such as urinary fistula may occur 8 Patients who experience postvoid incontinence or dribbling following surgery report their symptoms as resolved within three months 9 Satisfaction rates among patients who undergo metoidioplasty are generally very high regarding both appearance and sexual satisfaction 9 10 Comparison with phalloplasty editMetoidioplasty is technically simpler than phalloplasty more affordable and has fewer potential complications However phalloplasty patients are far more likely to be capable of sexual penetration mainly due to size constraints after they recover from surgery 11 In a phalloplasty a plastic surgeon fabricates a neopenis by autografting tissue from a donor site such as from the patient s back arm or leg A phalloplasty takes about 8 10 hours to complete the first stage and is generally followed by multiple up to three additional surgical procedures including glansplasty scrotoplasty testicular prosthesis and or penile implantation Metoidioplasty typically requires 2 3 hours to complete Because the clitoris erectile tissue functions normally a prosthesis is unnecessary for erection although the clitoris might not become as rigid as a penile erection In nearly all cases metoidioplasty patients can continue to have clitoral orgasms after surgery Note also that the two alternative techniques are not mutually exclusive and phalloplasty extension of a metioidiplasic base neophallus is possible 12 History editThe first metoidioplasty was reported in 1973 and the term was coined in a 1989 paper 13 14 See also edit nbsp Transgender portal nbsp Medicine portalList of transgender related topicsReferences edit Bordas N Stojanovic B Bizic M Szanto A Djordjevic ML 2021 10 13 Metoidioplasty Surgical Options and Outcomes in 813 Cases Frontiers in Endocrinology 12 760284 doi 10 3389 fendo 2021 760284 PMC 8548780 PMID 34721306 a b Hage JJ January 1996 Metaidoioplasty an alternative phalloplasty technique in transsexuals Plastic and Reconstructive Surgery 97 1 161 167 doi 10 1097 00006534 199601000 00026 PMID 8532774 S2CID 38412526 Perovic SV Djordjevic ML December 2003 Metoidioplasty a variant of phalloplasty in female transsexuals BJU International 92 9 981 5 doi 10 1111 j 1464 410x 2003 04524 x PMID 14632860 S2CID 11836091 Meyer WJ Webb A Stuart CA Finkelstein JW Lawrence B Walker PA April 1986 Physical and hormonal evaluation of transsexual patients a longitudinal study Archives of Sexual Behavior 15 2 121 38 doi 10 1007 BF01542220 PMID 3013122 S2CID 42786642 Perovic S and Djordjevic M 2003 Metoidioplasty a variant of phalloplasty in female transsexuals BJU International 92 981 985 doi 10 1111 j 1464 410X 2003 04524 x Djordjevic ML Stanojevic D Bizic M Kojovic V Majstorovic M Vujovic S Milosevic A Korac G Perovic SV May 2009 Metoidioplasty as a single stage sex reassignment surgery in female transsexuals Belgrade experience The Journal of Sexual Medicine 6 5 1306 13 doi 10 1111 j 1743 6109 2008 01065 x PMID 19175859 Cohanzad S February 2016 Extensive Metoidioplasty as a Technique Capable of Creating a Compatible Analogue to a Natural Penis in Female Transsexuals Aesthetic Plastic Surgery 40 1 130 8 doi 10 1007 s00266 015 0607 4 PMID 26744289 S2CID 40551674 Metoidioplasty Risks and Complications Is Metoidioplasty Really Worth It Trans Media Network a b Vukadinovic V Stojanovic B Majstorovic M Milosevic A 2014 The role of clitoral anatomy in female to male sex reassignment surgery TheScientificWorldJournal 2014 437378 doi 10 1155 2014 437378 PMC 4005052 PMID 24982953 De Cuypere G TSjoen G Beerten R Selvaggi G De Sutter P Hoebeke P et al December 2005 Sexual and physical health after sex reassignment surgery Archives of Sexual Behavior 34 6 679 90 doi 10 1007 s10508 005 7926 5 PMID 16362252 S2CID 42916543 Frey JD Poudrier G Chiodo MV Hazen A December 2016 A Systematic Review of Metoidioplasty and Radial Forearm Flap Phalloplasty in Female to male Transgender Genital Reconstruction Is the Ideal Neophallus an Achievable Goal Plastic and Reconstructive Surgery Global Open 4 12 e1131 doi 10 1097 GOX 0000000000001131 PMC 5222645 PMID 28293500 Al Tamimi M Pigot GL van der Sluis WB van de Grift TC van Moorselaar RJ Mullender MG et al November 2019 The Surgical Techniques and Outcomes of Secondary Phalloplasty After Metoidioplasty in Transgender Men An International Multi Center Case Series The Journal of Sexual Medicine 16 11 1849 1859 doi 10 1016 j jsxm 2019 07 027 PMID 31542350 S2CID 202731384 Bordas Noemi Stojanovic Borko Bizic Marta Szanto Arpad Djordjevic Miroslav L 2021 Metoidioplasty Surgical Options and Outcomes in 813 Cases Frontiers in Endocrinology 12 760284 doi 10 3389 fendo 2021 760284 PMC 8548780 PMID 34721306 Hage Joris J 1996 Metaidoioplasty An Alternative Phalloplasty Technique in Transsexuals Plastic and Reconstructive Surgery 97 1 161 167 doi 10 1097 00006534 199601000 00026 PMID 8532774 S2CID 38412526 Further reading editGreenwald D Stadelmann W July 2001 Gender reassignment EMedicine Journal 2 7 External links edit nbsp Media related to Metoidioplasty at Wikimedia CommonsMetoidioplasty net The Metoidioplasty Surgery Guide FemaletoMale org Information about Metoidioplasty Retrieved from https en wikipedia org w index php title Metoidioplasty amp oldid 1198847343, wikipedia, wiki, book, books, library,

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