ArticleInternational journal of impotence research2026
Single-stage dorsal-inlay augmented metoidioplasty: technique, complications, and patient-reported outcomes.
Article in International journal of impotence research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
Metoidioplasty is a genital gender-affirming surgery that preserves native sensation and erectile capability but remains technically demanding, particularly regarding urethral lengthening. We evaluated perioperative and functional outcomes of a single-stage modified metoidioplasty using dorsal labia minora graft augmentation, ventral anterior vaginal advancement flap reconstruction, and bilateral rotational scrotoplasty incorporating bilateral Martius fat pads. 23 transgender men underwent surgery at a tertiary referral center between 2017 and 2025. Median age was 38 (33-46) years and median follow-up was 36 (24-48) months. Median operative time was 165 (147.5-175) min and hospital stay was 2 (1.5-2.5) days. Early and late complications were observed in 13.0% of patients each. Cumulatively, urethral fistula and urethral stenosis occurred in 17.4 and 8.7% of patients, respectively. 2 (8.7%) fistulas resolved spontaneously, while 17.4% of patients required surgical revision. Patient-reported satisfaction was high, with 95.7% of patients satisfied with surgery and 91.3% reporting satisfaction with micturition and quality-of-life improvement using a non-validated binary questionnaire. This buccal mucosa graft-sparing, tissue-preserving approach appears feasible and safe, with urethral complication rates within the spectrum of outcomes reported in the literature, while potentially simplifying specific reconstructive steps and avoiding donor-site morbidity. Larger prospective comparative studies are warranted.
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