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Meltzer et al. Plast Aesthet Res 2020;7:61 Plastic and
DOI: 10.20517/2347-9264.2020.122 Aesthetic Research

Original Article Open Access

Metoidioplasty using labial advancement flaps for
urethroplasty

Toby R. Meltzer, Nick O. Esmonde

The Meltzer Clinic, Scottsdale, AZ 85253, USA.
Correspondence to: Dr. Toby R. Meltzer, The Meltzer Clinic, 7025 N Scottsdale Rd. Ste 302, Scottsdale, AZ 85253, USA.
E-mail: tmeltzer@tmeltzer.com

How to cite this article: Meltzer TR, Esmonde NO. Metoidioplasty using labial advancement flaps for urethroplasty. Plast Aesthet
Res 2020;7:61. http://dx.doi.org/10.20517/2347-9264.2020.122

Received: 22 May 2020 First Decision: 12 Aug 2020 Revised: 2 Sep 2020 Accepted: 10 Oct 2020 Published: 6 Nov 2020

Academic Editor: Marlon E. Buncamper Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Aim: A variation of the ring metoidioplasty has been performed for masculinizing transgender surgery by the
senior surgeon since 2010. It does not require buccal grafts or vaginal wall flaps. An excisional vaginectomy was
completed in all patients. We sought to evaluate the urologic outcomes and complications for this technique.
Further, we provide a detailed technical description of the technique, including ancillary masculinizing procedures.

Methods: This is a retrospective, single surgeon chart review of all patients undergoing metoidioplasty from
2010 to 2020. Demographics, outcomes, and complications are reported. A self-reported patient questionnaire
provided data on patient-perceived urologic outcomes.

Results: Ninety-one patients were included in the study, with 80 (87.9%) patients reporting ability to stand and
void with a strong stream. We observed five strictures (5.5%) and one fistula (1%). Scrotoplasty with tissue
expanders and testicular implants were performed in 75 (82.4%) patients, while monsplasty was performed in 54
(59%) patients.

Conclusion: Our technique has a low complication rate and patients report a strong urinary stream and the
ability to stand in the large majority of cases. Ancillary masculinizing procedures are common. The limitations
of metoidioplasty, in general, still persist, which are the small phallus size and variable ability to clear the zipper
without lowering the pants to void.

Keywords: Metoidioplasty, urethroplasty, transgender surgery, transmasculine surgery

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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