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Phalloplasty, or creation of a penis using transplanted tissue from elsewhere on the body, is a gender affirming procedure for transmen. It is performed with a urologist and gynecologist to remove the vagina and create a scrotum from the labia majora.
The goals of a phalloplasty are to be able to urinate in the standing position and to alleviate gender dysphoria. Implantation of scrotal implants or an erectile prosthesis is possible in a second procedure approximately a year after the initial phalloplasty. Donor sites for the tissue to create the phallus may include the forearm (radial forearm flap) or leg (anterolateral thigh flap) or a combination of both dependent on patient anatomy, BMI and patient preference.
Frequently Asked Questions
Who is a good candidate for phalloplasty surgery?
The UW Health team follows the World Professional Association for Transgender Health (WPATH) standards of care and requires that patients are 18 years of age and have two letters of readiness for surgery by mental health providers. Patients must be on hormonal therapy and live in an identity-congruent gender role for at least one year.
Phalloplasty surgery has been shown to have lasting benefit in mental and physical functioning in transmen who desire reconstructive surgery. Patients with prior history of metoidioplasty are candidates for phalloplasty surgery.
What should I do in the time leading up to my phalloplasty surgery?
Your doctor will give you instructions before your surgery, including guidelines on eating, drinking and taking or avoiding certain medications and vitamins. Avoid smoking or tobacco use four to six weeks before surgery and aspirin 14 days before and after your procedure.
Permanent hair removal with laser or electrolysis on the donor site skin is necessary to prevent urinary strictures and fistulas. This may require several sessions.
What should I expect following a phalloplasty procedure?
Immediately following phalloplasty surgery, you may experience temporary soreness, swelling, bruising, sickness upon waking from anesthesia and changes in sensation. You will have a suprapubic catheter in place for urine drainage and a transurethral drain through the new urethra. Your donor site, either the forearm or leg, will have a special dressing over a skin graft for five days. You will remain in the hospital for 10-14 days. Patients will be discharged from the hospital after they are able to void through the new urethra and suprapubic tube is removed.