What is penile reconstruction?

Penile reconstruction is a surgical procedure to create or restore a functional and aesthetic phallus. It is performed for a variety of reasons, including:

• Traumatic penile amputation
• Congenital defects, such as hypospadias and epispadias
• Penile cancer
• Genital mutilation
• Gender reassignment surgery for transgender men

There are a number of different techniques that can be used for penile reconstruction, depending on the specific needs of the patient. Some of the most common techniques include:

• Metoidioplasty: This procedure uses the clitoris and surrounding tissues to create a phallus. It is often used for transgender men who want to maintain sensation in their genitals.
• Phalloplasty: This procedure uses tissue from another part of the body, such as the forearm or thigh, to create a new penis. It is often used for patients who have lost their penis due to trauma or cancer.
• Urethral reconstruction: This procedure can be used to repair or create a new urethra, which is the tube that carries urine from the bladder to the outside of the body.

Penile reconstruction is a complex surgery, and there is no guarantee of a perfect outcome. However, most patients are able to achieve a functional and aesthetically pleasing phallus with the help of a skilled surgeon.

Here are some of the goals of penile reconstruction surgery:

• To create a phallus that is the correct size and shape for the patient’s body.
• To provide the patient with the ability to urinate standing up.
• To allow the patient to achieve sexual function, if desired.
• To improve the patient’s self-esteem and quality of life.

Penile reconstruction, also known as phalloplasty or penile construction surgery, is a gender-affirming surgical procedure that involves the creation of a neophallus (newly constructed penis) for individuals who are seeking to align their physical characteristics with their gender identity. This procedure is primarily performed as part of gender-affirming care for transgender and gender-diverse individuals, particularly those assigned female at birth (AFAB) who wish to have male-appearing genitalia.

Penile reconstruction can involve several surgical techniques, and the specific approach chosen depends on individual preferences, anatomy, and the expertise of the surgical team. The primary goal of this procedure is to provide a neophallus that is aesthetically and functionally similar to a natural penis, reducing gender dysphoria and enhancing an individual’s sense of self and body alignment.

Key aspects of penile reconstruction may include:

1. Phalloplasty: Phalloplasty involves the construction of a neophallus using tissue grafts, often from donor sites such as the forearm, thigh, or abdomen. The procedure may also involve the implantation of erectile devices to enable erections.
2. Metoidioplasty: Metoidioplasty is a procedure that involves releasing and extending the clitoral tissue, which has undergone testosterone-induced growth in transgender men who have been on hormone therapy. This procedure aims to create a smaller, but functional, neophallus.
3. Scrotoplasty: Scrotoplasty is often performed in conjunction with phalloplasty or metoidioplasty and involves the creation of a scrotum. Testicular implants may also be placed in the scrotum to provide a more masculine appearance.
4. Urethral Lengthening: Some individuals opt for urethral lengthening procedures to enable standing urination through the neophallus.
5. Glansplasty: The glansplasty procedure involves shaping and defining the head of the neophallus to create a more natural appearance.