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Metoidioplasty, sometimes referred to as a meto or meta, is an alternative to phalloplasty for Transmen ^[1]. With the effects of testosterone treatment, the clitoris enlarges, over time, to an average of 4-5 cm.^[2] (due to the clitoris and penis being developmentally homologous organs)

Surgery in a nutshell

In a metoidioplasty the enlarged clitoris is released from its position by cutting the lateral crura from the pubic bone, and moved forward to more closely approximate the position of a normal penis. In some cases the urethra is lengthened to end at the tip of the neophallus by using the labia minora tissues. The average neophallic length after metoidioplasty is 5.7 cm. (with a range 4–10 cm)

A step usually done at the same time during metoidioplasty surgery, is scrotoplasty. In this procedure, the labia majora (see vulva) are dissected to form hollow cavities, and united to into an approximation of a scrotum, where prosthetic testicles (usually made of silicone) can be inserted. Vaginectomy, Hysterectomy‎ and/or Oophorectomy (surgical removal of the overies) can also performed at this time if they have not been done so already.

Attributes

Metoidioplasty is technically simpler than a phalloplasty, and has fewer complications. Surgery itself is also considerably shorter (1-2 hours vs. 8-10 hours) and it is much less expensive. Unlike a phalloplasty, an erectile prosthesis is usually not needed to achieve erection, although the erection is usually less hard than in a cisgender penis. The clitoris contains erectile tissue which responds to sexual arousal. In most cisgender females, the clitoris is too small for the person to detect this erectile change significantly. In transmen and other female-bodied people whose clitoris is larger, this may be more visually apparent as it is in cisgender men.

Alternate techniques

If a metoidioplasty is performed without extending the urethral and/or a scrotoplasty, this is sometimes called a clitoral release. This is less expensive than a complete metoidioplasty but does not allow for urination (through the new penis) while standing. However this also offers surgery with less risk because the urinary system remains unaltered without a urethral extension and still affords some of the visual effects of a complete metoidioplasty. Vaginectomy is an option with this surgery.

See also

• Gender reassignment surgery (female-to-male)

Notes

• Metoidioplasty as a Single Stage Sex Reassignment Surgery in Female Transsexuals: Belgrade Experience by Miroslav L. Djordjevic, MD, PhD,* Dusan Stanojevic, MD, PhD - Journal of Sexual Medicine - Volume 6 Issue 5, Pages 1306 - 1313 - 27 Oct 2008
• Metaidoioplasty: An Alternative Phalloplasty Technique in Transsexuals Hage, J. Joris (Annals of Plastic Surgery)

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*Some information provided in whole or in part by http://en.wikipedia.org/