Adela Sobolewska,Kamila Mozga,Klaudia Ciupak et al. Adela Sobolewska et al.

Introduction: Metoidioplasty and phalloplasty are one of the most common surgeries among transgender patients, yet they still do not have any specific guidelines, how to perform each method....Methods: A total of 22 articles (9 metoidioplasty and 13 phalloplasty surgeries) were collected for the review and analyzed for postoperative urinary tract complications, life satisfaction, and sexual function of the patients....Results: Nine metoidioplasty articles presented a total of 2718 patients, while 13 articles focused on phalloplasty and provided 1300 cases....Discussion: It may seem that although phalloplasty results in more male-like looking genitalia, there is no significant difference in general satisfaction with the appearance of the neopenis between phalloplasty and metoidioplasty....Conclusions: This review has provided a comparative analysis of metoidioplasty and phalloplasty as 2 principal gender-affirming surgical options for transgender men.

Maya Levy,Emma L van Abbema,Brechje L Ronkes et al. Maya Levy et al.

Objective: To compare the long-term outcomes of the two main types of malleable erectile implants after phalloplasty in transgender men: models originally designed for cisgender men (conventional models) or the more recently developed Zephyr Surgical Implants (Geneva, Switzerland)...Patients and methods: A retrospective cohort study was conducted in patients who had undergone phalloplasty followed by insertion of a malleable implant between 2012 and 2015.

Yasmine Ibrahim,Maxwell Zywica,Michael R DeLong Yasmine Ibrahim

We present a novel local groin flap approach for phalloplasty with minimal visible scarring. The presented patient is a 32-year-old transgender male with a prior metoidioplasty....He desired phalloplasty to optimized standing micturition and sexual function but was unwilling to undergo standard radial forearm or anterolateral thigh due to high visible scar burden....A staged approach to phalloplasty was employed, using a lower abdominal random pattern flap to construct the phallus. Once healed, future stages will create a urethral channel with full thickness skin graft from the thigh to maintain a low scar burden....This technique can be considered for patients who do not desire the typical visible scarring with traditional phalloplasty methods.

Maya Levy,Marco Falcone,Julia Bohr et al. Maya Levy et al.

Background: Individuals undergoing phalloplasty as part of their gender-affirming medical transition are subsequently able to undergo insertion of a penile implant to achieve rigidity in the neophallus for penetrative intercourse.

Ellen Wang,Bennett Cleff,Anthony Basta et al. Ellen Wang et al.

Methods: This retrospective cohort study was conducted at a single institution of adult patients who underwent either phalloplasty with radial forearm (RFFF), anterolateral thigh (ALT) pedicled flaps, or pedicled abdominal flaps....On multivariate analysis, patients experiencing complications were more likely to have blood thinners (OR = 1.85, 95% CI: 1.05-3.25, p = 0.039) and less likely to undergo staged phalloplasty (OR = 0.91, 95% CI: 0.32-2.61)....Discussion: Flap choice for phalloplasty requires careful consideration between patients and providers. Pedicled abdominal flaps were associated with fewer complications, such as fistulas, urethral strictures, and reoperations.

Ahmet Demir Ahmet Demir

Introduction: Free flap phalloplasty and genital reconstruction have advanced significantly since the first reported case in 1982. Commonly used flaps include the radial forearm, anterolateral thigh (ALT), and ulnar forearm....Conclusion: The DLCFA represents a reliable, readily accessible, and anatomically favorable recipient vessel for free flap phalloplasty and pelvic reconstruction.

Ines Ana Ederer,Andrej Wehle,Carolin Wachtel et al. Ines Ana Ederer et al.

Background: The radial forearm free flap (RFFF) is the standard technique for gender-affirming tube-in-tube phalloplasty owing to its reliably vascular anatomy and pliable tissue....Aim: To quantify early postoperative circumferential and volumetric changes following RFFF phalloplasty in patients with an uneventful postoperative course....Methods: A consecutive series of trans men who underwent RFFF phalloplasty between 04/2024 and 07/2025 were analyzed. Phallic circumference was measured intraoperatively and on postoperative days (PODs) 1, 3, 5, 10, and 14 at three levels (base, midshaft, tip)....Strengths and limitations: This represents the first quantitative assessment of early postoperative swelling in phalloplasty based on multi-level measurements and volumetric modeling....Conclusions: RFFF phalloplasty demonstrates predictable swelling dynamics: rapid increase within 24 h, a peak on POD 3, and gradual decline thereafter, with persistent edema in most cases by POD 14.

Rados Djinovic,Milan Slavkovic Rados Djinovic

Zainab Yusufali Motiwala,Sidharth Misra,Arusha Desai et al. Zainab Yusufali Motiwala et al.

Transmasculine procedures such as phalloplasty and metoidioplasty are associated with urethral fistulas (15-60% and 10-25%, respectively), strictures (25-58% and ~ 20%), and urinary retention (25-58% and 15-25%). Lower urinary tract symptoms are also common.

Kristin B de Haseth,Danny A Young-Afat,Sterre E Mokken et al. Kristin B de Haseth et al.

Here, we present our surgical technique and surgical outcomes for pedicled SCIA-based phalloplasty without urethral lengthening (i.e. shaft-only) in transgender men....Methods: All transgender men who underwent shaft-only phalloplasty using SCIA-based perforator flaps between January 2017 and December 2023 were included in the analysis....Therefore, in our center, the SCIA-based perforator flap has become our primary choice for phalloplasty without urethral lengthening in slim patients.