Metoidioplasty is a gender reassignment surgery alternative to phalloplasty for transmasculine people. To understand the different stages of this surgery, we should explain that the clitoris, which has a structure similar to that of the penis, is made up of two parts:

• Cavernous bodies, which allow erection
• The spongy body, which includes the glans and generates sensitivity and sensations

Under the action of testosterone, the clitoris is enlarged (also called dicklit). The operation then involves “freeing” the dicklit, cutting the suspensory ligament and thus separating it from the labia minora, in order to lengthen it to make a small penis. During the operation, even if we achieve interesting length of 5 to 6cm in general, after a few months, the scarring causes a retraction of the tissues and cavernous bodies of the clitoris, thus reducing the size of the neo-penis.

In order to maintain the size obtained after the surgery, we suggest placing a prosthesis in the cavernous bodies during the intervention. A pair of small, malleable implants of 4mm in diameter and 12cm in length, can be cut if necessary and inserted into the corpora cavernosa. The main purpose of the implants is not to get an erection of the neo-penis. Their main function is to maintain the size of the neo-penis created from metoidioplasty, by preventing the retraction of the cavernous bodies of the clitoris.

During the metoidioplasty, the surgeon may suggest closing the vagina, making a scrotum, and lengthening the urinary tract to allow the patient to void while standing. Unlike phalloplasty, this surgery does not require a skin or nerve graft, and takes about 3 to 4 hours with implant placement. Although results vary depending on the size of the dicklit, penetration and maintenance of a very hard erection is very rare. In contrast, most patients who have had metoidioplasty still have the option of continuing to have clitoral orgasms after the operation.

Since 2017, several surgeons have carried out this implantation in several centers around the world. To find out how to contact them, do not hesitate to go to our map of implantation centers: https://www.zsimplants.ch/en/find-center/ftm-centers-map

ZSI is the only European manufacturer of artificial urinary sphincters and of malleable and inflatable penile implants, as solutions for male urological problems (incontinence), sexual complications (Erectile Dysfunction), and gender identity procedures (prostheses for transgender people).