Autologous Testicle Construction With Buried Metoidioplasty Correction

Summary:. Gender-affirming surgery is essential for transgender individuals seeking alignment between their physical appearance and gender identity. Metoidioplasty is a masculinizing option for those assigned female at birth and often includes vaginectomy, urethral lengthening, scrotoplasty, creatio...

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Main Authors: Payton J. Sparks, BS, Harley L. Moit, DO, Alan Tom, MD, Joshua Roth, MD, PhD, Ivan Hadad, MD, FACS
Format: Article
Language:English
Published: Wolters Kluwer 2024-12-01
Series:Plastic and Reconstructive Surgery, Global Open
Online Access:http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006368
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author Payton J. Sparks, BS
Harley L. Moit, DO
Alan Tom, MD
Joshua Roth, MD, PhD
Ivan Hadad, MD, FACS
author_facet Payton J. Sparks, BS
Harley L. Moit, DO
Alan Tom, MD
Joshua Roth, MD, PhD
Ivan Hadad, MD, FACS
author_sort Payton J. Sparks, BS
collection DOAJ
description Summary:. Gender-affirming surgery is essential for transgender individuals seeking alignment between their physical appearance and gender identity. Metoidioplasty is a masculinizing option for those assigned female at birth and often includes vaginectomy, urethral lengthening, scrotoplasty, creation of a neophallus, and testicular prostheses, typically implanted during a second-stage procedure. We describe a 39-year-old transgender man who initially underwent a laparoscopic hysterectomy, metoidioplasty, and tubularized plate urethral lengthening 19 months earlier. Although the patient could achieve an erection and orgasm, he struggled with standing urination due to the penis being buried by the mons pubis and upper labia majora. In addition, he feared superior migration of the testicular prostheses, which could diminish the prominence of the neophallus. We elected to perform a monsplasty with resection and rearrangement of excess upper labial tissue to mimic testicles. This approach helps avoid the risks associated with prostheses, using the patient’s own tissues instead. This second-stage operation enhances the appearance of the neophallus and creates the cosmetic appearance of testicles using the patient’s own tissues, offering a safe and effective surgical option. Although metoidioplasty offers significant benefits in terms of appearance and sensation, it has limitations, including the challenge of achieving standing urination due to the typically shorter length of the neophallus. We aimed to present the effectiveness and associated patient satisfaction with this innovative approach, showing its viability as a safe surgical option.
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series Plastic and Reconstructive Surgery, Global Open
spelling doaj-art-51cc29913c1a4f829cf662c35fa0b04e2025-08-20T02:39:56ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742024-12-011212e636810.1097/GOX.0000000000006368202412000-00012Autologous Testicle Construction With Buried Metoidioplasty CorrectionPayton J. Sparks, BS0Harley L. Moit, DO1Alan Tom, MD2Joshua Roth, MD, PhD3Ivan Hadad, MD, FACS4From the * Marian University College of Osteopathic Medicine, Indianapolis, IN† Division of Plastic Surgery, Indiana University, Indianapolis, IN† Division of Plastic Surgery, Indiana University, Indianapolis, IN‡ Department of Urology, Indiana University, Indianapolis, IN.† Division of Plastic Surgery, Indiana University, Indianapolis, INSummary:. Gender-affirming surgery is essential for transgender individuals seeking alignment between their physical appearance and gender identity. Metoidioplasty is a masculinizing option for those assigned female at birth and often includes vaginectomy, urethral lengthening, scrotoplasty, creation of a neophallus, and testicular prostheses, typically implanted during a second-stage procedure. We describe a 39-year-old transgender man who initially underwent a laparoscopic hysterectomy, metoidioplasty, and tubularized plate urethral lengthening 19 months earlier. Although the patient could achieve an erection and orgasm, he struggled with standing urination due to the penis being buried by the mons pubis and upper labia majora. In addition, he feared superior migration of the testicular prostheses, which could diminish the prominence of the neophallus. We elected to perform a monsplasty with resection and rearrangement of excess upper labial tissue to mimic testicles. This approach helps avoid the risks associated with prostheses, using the patient’s own tissues instead. This second-stage operation enhances the appearance of the neophallus and creates the cosmetic appearance of testicles using the patient’s own tissues, offering a safe and effective surgical option. Although metoidioplasty offers significant benefits in terms of appearance and sensation, it has limitations, including the challenge of achieving standing urination due to the typically shorter length of the neophallus. We aimed to present the effectiveness and associated patient satisfaction with this innovative approach, showing its viability as a safe surgical option.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006368
spellingShingle Payton J. Sparks, BS
Harley L. Moit, DO
Alan Tom, MD
Joshua Roth, MD, PhD
Ivan Hadad, MD, FACS
Autologous Testicle Construction With Buried Metoidioplasty Correction
Plastic and Reconstructive Surgery, Global Open
title Autologous Testicle Construction With Buried Metoidioplasty Correction
title_full Autologous Testicle Construction With Buried Metoidioplasty Correction
title_fullStr Autologous Testicle Construction With Buried Metoidioplasty Correction
title_full_unstemmed Autologous Testicle Construction With Buried Metoidioplasty Correction
title_short Autologous Testicle Construction With Buried Metoidioplasty Correction
title_sort autologous testicle construction with buried metoidioplasty correction
url http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006368
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