A narrative review of outcomes following metoidioplasty: complications and satisfaction

Abstract

Metoidioplasty consists of lengthening and straightening the hormonally hypertrophied clitoris. The goals of the procedure include masculinizing the external genitalia and enabling standing micturition. Metoidioplasty may be performed as a stand-alone procedure or an interval procedure prior to phalloplasty. While most often performed with urethral lengthening, metoidioplasty may also be performed as a “simple release” (i.e., without urethral lengthening). Secondary procedures typically include scrotoplasty and placement of testicular implants. While satisfaction with this procedure is high, complications can occur. Complications are commonly categorized as either urologic (i.e., strictures and fistula) or wound healing (i.e., wound disruption, infection, bleeding, etc.). This narrative review discusses postoperative outcomes, including both satisfaction and complications. Published data on complications include fistula and stricture rates from 0%-50% and 0%-63%, respectively. Overall satisfaction with appearance ranges from 48%-100%, and patient ability to void while standing ranges from 67%-100%. Metoidioplasty is a safe and effective procedure for transgender men. Further research regarding surgical techniques and outcomes will help reduce complications and improve overall patient satisfaction.

Keywords

Metoidioplasty / stricture / fistula / gender-affirmation surgery / transgender / genital reconstruction / complication / satisfaction / outcome

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