CECM

Genital surgical procedures for female to male patients include:

• Vaginectomy: resection and closure of the vaginal cavity
• Metoidioplasty: release of the clitoris to create a micro penis
• Scrotoplasty: construction of the scrotum from the upper lips
• Uretroplasty: repositioning of the urethra
• Placement of testicular prosthesis
• Phalloplasty: construction of the penis

There are currently a variety of surgical techniques for phalloplasty. The choice of the technique may be limited by anatomical or surgical considerations. The goals of phalloplasty are to create neofalo of good appearance, standing urination, sexual sensation, and / or coital ability, patients should be clearly informed that there are several separate stages of surgery and frequent technical difficulties that may require additional operations. Even metoidioplasty, which in theory is a single-stage procedure for building a microphalon, often requires more than one operation. The goal of standing urination with these techniques cannot always be guaranteed.

Complications of phalloplasty may include frequent stenosis and fistulae of the urinary tract and, occasionally, necrosis of the neofalo. Metodioplasty results in a micropenis with the ability to urinate standing up. Phalloplasty, using a pedicle or a free vascularized flap, is a long, multi-stage procedure with significant morbidity including frequent urinary complications and inevitable scarring in the donor part of the body.

Average time: 8-12  hours
Type of anesthesia: General o Epidural + sedation

Prerequisites:

Mandatory:

• Adult age
• Assessment by psychiatry or psychology to confirm good mental health.
• Emotionally stable
• Medically healthy with any medical conditions being treated and under control.
• Living as a male 24 hours a day at least for one year in a row.

Optional:

• Support of spouse, family, significant other, friends

Frequently asked questions:

¿Who performs my hysterectomy?
It must be done by a gynecologist, ideally transvaginal or laparoscopically.

¿ Is it necessary to wait any specific length of time after a hysterectomy has been performed before a phalloplasty is done?
If a hysterectomy has already been performed, it would be wise to wait at least six months prior to phalloplasty so healing and reduction of swelling and inflammation can be sufficiently advanced in order to not interfere with the phalloplasty procedure.

¿Is it necessary to have a vaginectomy before getting phalloplasty?
Vaginectomy can be done at the same time with hysterectomy or with phalloplasty.

¿ Is a scrotoplasty included as part of the same stage phalloplasty?
Yes, ideally we recommend that the scrotoplasty is done at the same thime with phalloplasty.

¿Which technique do you use for phalloplasty?
The first choice for phalloplasty is abdominal skin graft or leg  muscular graft.

¿ How do you incorporate the clitoral nerves to the neo-phallus during the phalloplasty procedure?
The clitoral nerves and clitoral sensation are maintained by preserving the entire clitoris.  The clitoris can be left in place or can be transposed and buried under the skin between the scrotum and the penis.

¿ Is the phalloplasty done in one stage or more than one stage?
I prefer to do the entire phalloplasty in one stage and this includes the creation of the neo-phallus, clitoral transposition, glansplasty, and scrotoplasty with testicular implants.

¿ What kind of scars are left on the neo-phallus and will they eventually disappear?
With our technique, scars are located in the lower abdomen and in the medial line of the scrotum. They are permanent, but with time they improve their appearance. During the first several months, scars can be pink, raised and wide, but from around 6 – 12 months the scars become flat, soft and white and not very obvious.

¿ What is the functional result of the neo-phallus?
There is no technique available in the world today which can create a penis which can have a natural erection.  We simply do not have the ability to create the thousands of small blood vessels required to achieve a natural erection and so we must choose another form of support if the patient desires the ability to have intercourse.  This support can be either internal or external.  Internal support means placing some type of penile implant into the center of the phalloplasty flap.  External support consists in placing one or two condoms over the penis which can give sufficient rigidity to allow intercourse.

¿ How long does it take me to recover from phalloplasty?
You must stay for 5-7 days in the hospital after the procedure and at least 6 weeks in the city of Cali.

¿ When can I go back to work after phalloplasty?
Generally, barring any unforeseen complications, phalloplasty patients can return to work after about 6 weeks depending on the patient’s recuperative progress and the type of work.