Metoidioplasty is a surgical procedure preferred by trans men (FTM) during their gender affirmation journey, enabling the creation of an aesthetic and functional neophallus using the body\u2019s own natural tissues. This method aims to preserve natural sensation and nerve structure by maximizing the potential of existing tissues through microsurgical principles. Without requiring distant tissue transfer, this operation transforms the anatomical structure that has gained volume through hormone therapy into a masculine form and is one of the most critical medical steps completing individuals\u2019 bodily integrity. Performed with modern plastic surgery techniques, this process provides physical transformation while permanently increasing the person\u2019s self-confidence and quality of life.<\/p>\n
| What Is Metoidioplasty?<\/span><\/td>\n | Metoidioplasty is a surgical procedure performed within the scope of gender affirmation surgery that aims to release the clitoris enlarged through testosterone therapy and give it a more prominent and functional penile appearance.<\/span><\/td>\n<\/tr>\n| Primary Purpose<\/span><\/td>\n | Its purpose is to masculinize the genital appearance, improve urinary function when urethral lengthening is performed, preserve sexual function, and create a genital structure consistent with the person\u2019s gender identity.<\/span><\/td>\n<\/tr>\n | How Is the Surgery Performed?<\/span><\/td>\n | The connective tissues pulling the clitoris downward are released. When necessary, the urethra is lengthened, a scrotum is created through scrotoplasty, and testicular implants may be placed at later stages. The surgical technique may vary according to the patient\u2019s anatomy and goals.<\/span><\/td>\n<\/tr>\n | Urethral Lengthening<\/span><\/td>\n | It is optional. When performed, the goal may be to enable the person to urinate while standing. However, the risk of urethral complications may also increase.<\/span><\/td>\n<\/tr>\n | Condition of the Vagina<\/span><\/td>\n | The vagina may be preserved, or vaginectomy involving closure or removal of the vagina may be performed during the same operation or in a separate session. This decision depends on individual preferences and the surgical plan.<\/span><\/td>\n<\/tr>\n | Scrotoplasty<\/span><\/td>\n | A scrotum may be created from the labia majora. Testicular implants may later be placed when considered appropriate.<\/span><\/td>\n<\/tr>\n | Penis Size<\/span><\/td>\n | The size of the resulting penis largely depends on the clitoral growth achieved through testosterone therapy and varies from person to person.<\/span><\/td>\n<\/tr>\n | Sexual Sensation<\/span><\/td>\n | Since the nerve structure of the clitoris is preserved, touch sensation and erotic sensation are generally maintained.<\/span><\/td>\n<\/tr>\n | Ability to Achieve Orgasm<\/span><\/td>\n | The ability to achieve orgasm is preserved in most patients. The surgical technique and individual differences may affect the outcome.<\/span><\/td>\n<\/tr>\n | Erection<\/span><\/td>\n | Since the created penis consists of natural erectile tissue, it can become erect spontaneously. An additional erectile implant is generally not required.<\/span><\/td>\n<\/tr>\n | Ability to Urinate While Standing<\/span><\/td>\n | This may be possible in individuals whose urethral lengthening is successful. However, it cannot be guaranteed for every patient.<\/span><\/td>\n<\/tr>\n | Surgery Duration<\/span><\/td>\n | Although it varies depending on the procedures performed, it generally takes several hours.<\/span><\/td>\n<\/tr>\n | Anesthesia<\/span><\/td>\n | It is mostly performed under general anesthesia.<\/span><\/td>\n<\/tr>\n | Hospital Stay<\/span><\/td>\n | Depending on the scope of the surgery, hospitalization for several days may be required.<\/span><\/td>\n<\/tr>\n | Recovery Process<\/span><\/td>\n | Initial healing takes several weeks, while complete recovery and tissue maturation may take months.<\/span><\/td>\n<\/tr>\n | Catheter Use<\/span><\/td>\n | A urinary catheter may be used for a certain period in patients who undergo urethral lengthening.<\/span><\/td>\n<\/tr>\n | Possible Risks<\/span><\/td>\n | Bleeding, infection, wound healing problems, hematoma, urethral fistula, urethral stricture, urinary leakage, implant-related complications when implants are placed, aesthetic dissatisfaction, and the need for additional surgery may occur.<\/span><\/td>\n<\/tr>\n | Urethral Fistula<\/span><\/td>\n | It is a complication that causes urine to leak through an unintended opening and may require additional surgery.<\/span><\/td>\n<\/tr>\n | Urethral Stricture<\/span><\/td>\n | Difficulty urinating may develop as a result of narrowing of the urinary canal and may require treatment.<\/span><\/td>\n<\/tr>\n | Advantages<\/span><\/td>\n | Possible advantages include preserving natural sensation and erection, requiring less tissue transfer, providing a shorter surgery duration, and involving a lower surgical burden compared with phalloplasty.<\/span><\/td>\n<\/tr>\n | Limitations<\/span><\/td>\n | The limited penis size, the possibility that it may not always be sufficient for penetrative sexual intercourse, and the inability of some patients to urinate while standing are important limitations.<\/span><\/td>\n<\/tr>\n | Alternative Surgery<\/span><\/td>\n | Phalloplasty is an alternative genital reconstruction method that aims to create a larger penis. The appropriate method is determined according to the person\u2019s expectations, anatomical structure, and surgical goals.<\/span><\/td>\n<\/tr>\n | Follow-Up<\/span><\/td>\n | Regular surgical checkups, wound care, evaluation of urinary function, and long-term follow-up are recommended.<\/span><\/td>\n<\/tr>\n | Expected Outcome<\/span><\/td>\n | Following successful metoidioplasty, the aim is for the person to achieve their anatomical, functional, and psychosocial goals. Results may vary according to the technique applied, individual anatomy, and the healing process.<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n | |