REVIEW   Free access

Minerva Urologica e Nefrologica 2020 February;72(1):38-48

DOI: 10.23736/S0393-2249.19.03611-7

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

What urologists need to know about female-to-male genital confirmation surgery (phalloplasty and metoidioplasty): techniques, complications, and how to deal with them

Min S. JUN ¹ ✉, Curtis N. CRANE ², Richard A. SANTUCCI ²

¹ Department of Reconstructive Urology and Trauma, NYU Langone Health, New York, NY, USA; ² Crane Center for Transgender Surgery, Austin, TX, USA

Transmasculine gender-affirming surgery (GAS) is technically challenging, and in the past associated with a high but improving complication rate. Few surgical centers are performing this surgery, which can include metoidioplasty and phalloplasty, and patients often travel great distances for their surgery. While many will continue care with their original surgeons, others cannot due to social/geographic factors, or because emergencies arise. Thus, patients may seek care with their local urologist for relief of delayed complications, the most common of which include urethral stricture, penile prosthesis issues and urethrocutaneous fistula. This review will discuss the surgical elements behind metoidioplasty and phalloplasty, and the diagnosis and treatment for the most common postoperative issues.

KEY WORDS: Transgender persons; Gender dysphoria; Sex reassignment surgery; Fistula; Urethral stricture