Pd31-12 Psychosexual Outcomes and Quality of Life After Metoidioplasty in Transmen

You have accessJournal of UrologyReconstruction: External Genitalia and Urotrauma (including transgender surgery and traumatic fistula) I (PD31)1 May 2024PD31-12 PSYCHOSEXUAL OUTCOMES AND QUALITY OF LIFE AFTER METOIDIOPLASTY IN TRANSMEN Borko Stojanovic, Marta Bizic, Marko Bencic, and Miroslav L. Djordjevic Borko StojanovicBorko Stojanovic , Marta BizicMarta Bizic , Marko BencicMarko Bencic , and Miroslav L. DjordjevicMiroslav L. Djordjevic View All Author Informationhttps://doi.org/10.1097/01.JU.0001009432.48553.4f.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The surgical goals of metoidioplasty are male appearance of genitalia, with good cosmetic and functional outcome, achieved in a one-stage surgery. However, the ultimate objectives are patients' satisfaction and improved quality of life, which are evaluated in this study. METHODS: Between December 2016 and December 2022, 243 transmen underwent one-stage metoidioplasty with urethral lengthening. Out of them, 165 transmen with the mean age of 28 years (ranged from 18 to 58 years) took part in the study. Surgery included lengthening and straightening of the clitoris, urethral lengthening using buccal mucosa graft and vascularized flaps, scrotoplasty with testicular implants. Two questionnaires were used. One is designed for transmen in our center and includes 17 questions to evaluate surgical and psychosexual outcomes. A WHOQOL-BREF was used preoperatively and postoperatively, measuring 4 health domains (physical, psychological, social relationship and environment). RESULTS: Follow-up ranged from 6 to 78 months. Mean length of the neophallus was 6.2 cm. Urethral fistula and stricture occurred in 20 (12%) and 4 (2.5%) cases, respectively. Other complications included testicular implant rejection in 5, testicular displacement in 7 and vaginal remnant in 18 cases. All patients reported satisfaction with aesthetic result (60% completely and 40% somewhat satisfied). Erogenous sensitivity and quality of erection are preserved in all cases, and only 1 patient reported possibility for penetrative sexual intercourse. Regarding postoperative overall sexual satisfaction, 115 transmen (69.7%) are very satisfied, 37 (22.4%) somewhat satisfied, and 13 (7.9%) dissatisfied. Grading overall sexual satisfaction from 1 to 5, mean postoperative grade of 3.64 was significantly higher than preoperative of 2.21. Results of WHOQOL-BREF revealed improvement in postoperative compared to preoperative scores in all domains: I - 80.4:80.2; II - 70.5:57.5; III - 72.2:62.3; IV - 79.0:74.0. Statistically significant difference (p<0.001) is determined in every domain, especially in psychological health domain. There were no regrets after surgery. From 165 transmen, 28 (17%) requested total phalloplasty after metoidioplasty, wishing to achieve more natural male appearance and better sexual function. CONCLUSIONS: One-stage metoidioplasty has very good aesthetic and functional outcomes, with low rate of complications. Sexual satisfaction and quality of life are significantly improved after surgery. However, up to 20% of transmen after metoidioplasty require total phalloplasty. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e634 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Borko Stojanovic More articles by this author Marta Bizic More articles by this author Marko Bencic More articles by this author Miroslav L. Djordjevic More articles by this author Expand All Advertisement PDF downloadLoading ...