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Metoidioplasty Journal Articles

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NEW! A Systematic Review of Metoidioplasty and Radial Forearm Flap Phalloplasty in Female-to-male Transgender Genital Reconstruction: Is the Ideal Neophallus an Achievable Goal?
Frey, Jordan D. MD; Poudrier, Grace BA; Chiodo, Michael V. MD; Hazen, Alexes MD. Plastic and Reconstructive Surgery, December 2016 - Volume 4 - Issue 12.
The complex anatomy and function of the native penis is difficult to surgically replicate. Metoidioplasty and radial forearm flap phalloplasty (RFFP) are the 2 most commonly utilized procedures for transgender neophallus construction. Although the current literature suggests that metoidioplasty is more likely to yield an "ideal" neophallus compared with RFFP, any conclusion is severely limited by the low quality of available evidence.

The Role of Clitoral Anatomy in Female to Male Sex Reassignment Surgery
Vojkan Vukadinovic, Borko Stojanovic, Marko Majstorovic, and Aleksandar Milosevic.
The Scientific World Journal, Volume 2014 (2014), Article ID 437378, 7 pages
Accurate knowledge of the clitoral anatomy, relations, and neurovascular supply is crucial for achieving a successful outcome. Release of all anatomical layers of suspensory ligaments, followed by precise dissection of short urethral plate, is necessary for a complete straightening and lengthening of the clitoris. Preservation of the neurovascular supply, as well as dorsal aspect of the glans, is essential in maintaining sexual function.

Comparison of Two Different Methods for Urethral Lengthening in Female to Male (Metoidioplasty) Surgery.
Djordjevic ML, Bizic MR. J Sex Med. 2013 Feb 27. doi: 10.1111/jsm.12108. Also see: Article Review

Metoidioplasty as a single stage sex reassignment surgery in female transsexuals: Belgrade experience.
Djordjevic ML, Stanojevic D, Bizic M, Kojovic V, Majstorovic M, Vujovic S, Milosevic A, Korac G, Perovic SV. J Sex Med. 2009 May;6(5):1306-13. Epub 2009 Oct 27.
Metoidioplasty is a single-stage and time-saving procedure that can be employed as an alternative to total phalloplasty in FTM transsexuals, or as a first step in cases where additional augmentation phalloplasty is required.

Labial ring flap: a new flap for metaidoioplasty in female-to-male transsexuals.
Takamatsu A, Harashina T. J Plast Reconstr Aesthet Surg. 2009 Mar;62(3):318-25. Epub 2009 Jan 24.
This new technique uses all the labia minora skin incorporated with the anterior vaginal flap for urethral lengthening. The clitoral chordee is also released by this procedure.

Long-term outcome of metaidoioplasty in 70 female-to-male transsexuals.
Hage JJ, van Turnhout AA.Ann Plast Surg. 2006 Sep;57(3):312-6.
While metaidoioplasty is a method of choice in selected patients, the procedure cannot usually be completed in one step. Phalloplasty is feasible subsequent to metaidoioplasty.

FEATURED - Metoidioplasty: a variant of phalloplasty in female transsexuals
S.V. Perovic, M.L. Djordjevic. BJU International, Volume 92, Issue 9, pages 981-985, December 2003
Metoidioplasty is a technique for creating a neophallus from an enlarged clitoris in female to male transsexuals.

FEATURED - Beginnings of Sex Reassignment Surgery in Japan
Takamatsu Ako, M.D., Harashina Takao, M.D., Inoue Yoshiharu, M.D., Kinoshita Katsuyuki, M.D., Ishihara Osamu, M.D., Uchijima Yutaka, M.D., Department of Plastic and Reconstructive Surgery, Gynecology, Urology, Saitama Medical Center, Saitama Medical School, Japan. The International Journal of Transgenderism, Volume 5, Number 1, January - March 2001.

Metaidoioplasty: an alternative phalloplasty technique in transsexuals.
Hage JJ. Plast Reconstr Surg. 1996 Jan;97(1):161-7.
Metaidoioplasty uses the clitoris, overdeveloped by hormonal treatment, to construct a microphallus in a way comparable to the correction of chordae and lengthening of urethra in cases of severe hypospadias.


NEW! Robot-assisted laparoscopic colpectomy in female-to-male transgender patients; technique and outcomes of a prospective cohort study [Full text]
Freek Groenman, Charlotte Nikkels, Judith Huirne, Mick van Trotsenburg, Hans Trum
Surgical Endoscopy, August 2017, Volume 31, Issue 8, pp 3363–3369.
Study results show that [robot-assisted laparoscopic Vaginectomy] combined with [robot-assisted laparoscopic Hysterectomy] is feasible as a single-step surgical procedure in FtM transgender surgery.

NEW! Laparoscopic Vaginal-Assisted Hysterectomy With Complete Vaginectomy for Female-To-Male Genital Reassignment Surgery.
Gomes da Costa A, Valentim-Lourenço A, Santos-Ribeiro S, Carvalho Afonso M, Henriques A, Ribeirinho AL, Décio Ferreira J. J Minim Invasive Gynecol. 2016 Mar-Apr;23(3):404-9.
This study suggests the feasibility of laparoscopic vaginectomy in genital reassignment surgery. The procedure can be executed as a continuation of the hysterectomy with the potential advantage of the laparoscopy providing better exposure of the anatomic structures with low blood losses (less than 500 mL) and few complications. Furthermore, using this approach, adequate-sized vaginal mucosa flaps were obtained for the urethral reconstruction.

Outcome and Risk Factors for Vaginectomy in Female to Male Transsexuals
M. Spilotros, DJ Ralph, N Christopher, Institute of Urology London, presented at the World Meeting on Sexual Medicine. 2013.
This presentation includes reasons, treatment and results for vaginectomy. Complications are few and easy to manage. The severity of bleeding is directly related to vaginal length. Patients report high satisfaction rates.

Colpocleisis: a review.
FitzGerald MP, Richter HE, Siddique S, Thompson P, Zyczynski H; Ann Weber. Int Urogynecol J Pelvic Floor Dysfunct. 2006 May;17(3):261-71. Epub 2005 Jun 28.
Summarizes published data about colpocleisis (in women) and to highlight areas about which data are lacking.

Vaginectomy and laparoscopically assisted vaginal hysterectomy as adjunctive surgery for female-to-male transsexual reassignment: preliminary report.
Ergeneli MH, Duran EH, Ozcan G, Erdogan M. Eur J Obstet Gynecol Reprod Biol. 1999 Nov;87(1):35-7.


Pedicled superficial inferior epigastric artery perforator flap for salvage of failed metoidioplasty in female-to-male transsexuals.
Schmidt M., Grohmann M., Huemer GM. Microsurgery. 2014 Dec 2. doi: 10.1002/micr.22361. [Epub ahead of print]
In a 26-year-old transsexual patient a combination of urethral fistula, urethral stenosis, and disintegrated distal neourethra had developed as a consequence of postoperative hematoma formation. Metoidioplasty was reconstructed by means of a tubed, pedicled superficial inferior epigastric artery perforator flap from the left lower abdomen. The long-term result was stable with pleasing genital appearance, adequate functional outcome, and satisfactory donor site morbidity. In our opinion, this procedure may represent a viable alternative for urethral reconstruction in thin patients.

Urethral Lengthening in metoidioplasty (female-to-male sex reassignment surgery) by combined buccal mucosa graft and labia minora flap.
Djordjevic ML, Bizic M, Stanojevic D, Bumbasirevic M, Kojovic V, Majstorovic M, Acimovic M, Pandey S, Perovic SV. Urology. 2009 Aug;74(2):349-53. Epub 2009 Jun 7.
Urethral lengthening is the most difficult part in female to male transsexuals and poses many challenges. A combined buccal mucosa graft and labia minora flap present a good choice for urethral reconstruction with minimal postoperative complications.

Saving labium minus skin to treat possible urethral stenosis in female-to-male transsexuals.
Hage JJ, van Turnhout AA, Dekker JJ, Karim RB. Ann Plast Surg. 2006 Apr;56(4):456-9.
Neourethral stenosis is the main complication following metaidoioplasty in female-to-male transsexuals. We introduce the use of surplus of minor labial skin to correct these stenoses.

Review of the literature on construction of a neourethra in female-to-male transsexuals.
Hage JJ, Bloem JJ. Ann Plast Surg. 1993 Mar;30(3):278-86.
A review of the literature on the construction of a pars pendulans and a pars fixa urethrae in phalloplasty is given. The use of local tissue for lengthening of the fixed part of the urethra can be successful in case a vaginal flap is incorporated.


Scrotal reconstruction in female-to-male transsexuals: a novel scrotoplasty.
Selvaggi G, Hoebeke P, Ceulemans P, Hamdi M, Van Landuyt K, Blondeel P, De Cuypere G, Monstrey S
Plast Reconstr Surg. 2009 Jun;123(6):1710-8.

Testicular Prostheses: Development and Modern Usage
D Bodiwala, DJ Summerton, and TR Terry. Ann R Coll Surg Engl. 2007 May; 89(4): 349–353.
Testicular prostheses produced from various materials have been in use since 1941. The most common substance used around the world in the manufacture of these implants is silicone; however, in the US, this material is currently banned because of theoretical health risks. This has led to the development of saline-filled prostheses as an alternative. The long-term fears associated with silicone implants, namely connective tissue or autoimmune diseases and carcinogenesis, have not been substantiated. Longer-term quality-of-life results are still pending.

NEW! Scrotal construction by expansion of labia majora in biological female transsexuals.
Sengezer M, Sadove RC. Ann Plast Surg. 1993 Oct;31(4):372-6.
In each patient, tissue expanders were inserted into the labia majora several months before free flap phalloplasty. The anatomical position of the labia majora produces a scrotum properly located in relation to surrounding anatomical structures. Excellent aesthetic results can be achieved with this procedure.

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Last updated: 08/15/17