Metaidoioplasty is the surgical creation of a penis using your existing hypertroffic genital tissue induced by hormone use. It is a less-extensive procedure than phalloplasty and is performed after the clitoris has been enlarged through testosterone therapy. It is possible to undergo phalloplasty after a metoidioplasty, the reverse is impossible.
What to expect
Pre-operative:
- Before you are eligible for a metaidoioplasty, you need to take hormone therapy for at least one year.
- You will be given guidelines on eating, drinking and adjusting current medications before the surgery can take place.
- Bring a list of your questions and concerns to your pre-operative visits. Understanding the expectation for recovery, based on your plan, is essential.
- You will need surgery referral letters from two qualified mental health professionals.
- Smoking is a relative contra-indication to subcutaneous mastectomy. Because of the increased risk of infection i.a., you are advised to stop smoking as soon as possible.
- After you have discussed which surgery technique is best for you, Dr Kanhai will draw up a plan for the operation.
- The anaesthesiologist will provide information on the anaesthesia, and doctor Kanhai about the type of the operation, and the follow-up procedures that might be necessary.
- Dr Kanhai will also ask about any risk factors for blood clotting issues (past deep vein thrombosis or pulmonary embolism), bleeding problems (like haemophilia), or family/personal history of issues with anaesthesia.
- You will undergo a physical examination to ensure readiness for the operation.
Peri-operative:
- We will give you general anaesthesia through a vein in your arm. You will be asleep throughout the procedure and won’t feel any pain during surgery. The procedure can take approximately three hours.
- During a metaidoioplasty, Dr Kanhai will use the tissue from your enlarged clitoris to form a micropenis.
- Dr Kanhai will insert a plastic tube (catheter) into the bladder that is threaded through the neophallus to keep the urethral space open.
- After that, he will use the labia minora tissue to enlengthen the urethra. And the labia majora will be used to create a scrotum with fat tissue from the mons pubis region.
- Hypertrophic genital tissue will be used to increase the length and girth of the neophallus.
Post-operative:
- After a metoidioplasty, you will need time to heal and you may need to stay in the hospital for 1 or 2 days. This surgery has a very long healing process that can take 3 to 4 months.
- You will likely be able to walk around and engage in light activities within a week after surgery, but you should not engage in strenuous physical activities or heavy lifting in the first 6 weeks after the procedure.
- If you undergo urethral lengthening as part of metoidioplasty, you will have a supra pubic catheter for 3 weeks and a urethral catheter for 5 days.
- We will give you detailed instructions on caring for the catheters and checking for signs of infection at the surgical site, such as redness and swelling.
