Optimization of Second-stage Metoidioplasty.

Autor: Odeluga N; Western University of Health Sciences, Pomona, CA., Reddy SA; Texas Tech Health Sciences Center School of Medicine, Lubbock, TX., Safir MH; Crane Center for Transgender Surgery, San Francisco, CA., Crane CN; Crane Center for Transgender Surgery, Austin, TX., Santucci RA; Crane Center for Transgender Surgery, Austin, TX. Electronic address: richard@cranects.com.
Jazyk: angličtina
Zdroj: Urology [Urology] 2021 Oct; Vol. 156, pp. 303-307. Date of Electronic Publication: 2021 Jun 02.
DOI: 10.1016/j.urology.2021.04.045
Abstrakt: Objective: To describe a planned 2-staged metoidioplasty. Metoidioplasty is a genital gender-affirmation surgery aimed at creating a neophallus, scrotum (if desired), and flat male-type perineum (if desired) from natal tissues. It generally requires a planned second-stage to place testes prostheses, address complications, and perform additional surgical steps to maximally lengthen the phallus. The details of this procedure are sparsely mentioned in the literature. We found that phallus length can be optimized in the second-stage by applying surgical principles already established in the surgical treatment of adult acquired buried penis.
Material and Methods: We conducted a retrospective chart review of patients after metoidioplasty between August 2015 and June 2020, and isolated those that underwent second-stage metoidioplasty. Each procedure was done by 1 of 4 surgeons in a single practice in 2 locations, San Francisco, CA, and Austin, TX. Details of procedures required, complications, and demographic information were recorded.
Results: Out of the 75 patients that had undergone metoidioplasty, 37 (37 of 75, 49%) underwent a second-stage metoidioplasty. Reduction of upper scrotal blocking tissue was the most common procedure performed during a second-stage metoidioplasty (31 of 37, 84%), followed by escutcheonectomy/penile lift (30 of 37, 81%), bilateral implant placement (20 of 37, 54%), chordee repair (13 of 37, 35%), and unilateral implant placement (1 of 37, 3%). 6 of the 37 patients (16%) developed major complications. 5 of the 37 (5 of 37, 15%) second-stage patients required a redo second-stage metoidioplasty.
Conclusion: Second-stage metoidioplasties are commonly performed on patients to optimize results of phallic lengthening and release, and to repair complications that arise after single-stage metoidioplasty. Escutcheonectomy/penile lift, placement of scrotal implants, repair of chordee, and upper scrotal blocking tissue reduction are procedures that are often performed during a second-stage metoidioplasty.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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