In 1996, metaidoioplasty was introduced as an alternative to phalloplasty in female-to-male transsexuals. To assess the long-term outcome in 70 consecutive patients (mean follow-up 8 years), we established the characteristics of postoperative events and additional surgical procedures.
Metaidoioplasty and primary or secondary scrotoplasty was uneventful in 8 patients. In the other patients, postoperative events included immediate postoperative complications (n = 23), urethral fistulas (n = 26) or strictures (n = 25), or loss (n = 22) or dislocation (n = 34) of testicular prostheses. An average of 2.6 surgical procedures per patient was needed to complete genital confirmation and cope with all events. Additional phalloplasty was performed or scheduled in 17 patients.
We conclude that genital reassignment by metaidoioplasty cannot usually be completed in 1 step and that phalloplasty is feasible subsequent to metaidoioplasty. We still consider metaidoioplasty to be a method of choice in selected patients.
Seventy female-to-male transsexuals underwent stretching of the hypertrophied clitoris by resection of the ventral chordee, lengthening of the urethra with labia minora skin flaps, and scrotal construction with labia majora flaps. Because of a high number of complications, the authors recommend it only in selected patients.
From the Department of Plastic and Reconstructive Surgery at the Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
Received February 12, 2006 and accepted for publication March 19, 2006.
Reprints: J. Joris Hage, MD, PhD, Department of Plastic and Reconstructive Surgery, Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, NL-1066 CX Amsterdam, The Netherlands. E-mail: firstname.lastname@example.org.