The surgical procedure to construct penis is called phalloplasty. The aims of phalloplasty are:
- Male genitals cosmetically looking as natural as possible.
- Ability to perform sexual intercourse.
- Ability to attain orgasm.
The erectile and functional penis requires two stages for reconstruction:
Phalloplasty Stage I
There are two techniques for penile reconstruction depending on the donor tissue site.
- The penis is constructed using local skin tissues like groin, lower abdomen or from thighs. The skin is tabularized to give penile shape.
- The more common and popular procedure to construct penis is a free flap, in which the tissues including the blood vessels and arteries are removed from any other part of body. The most common donor site is forearm ( Radial artery forearm flap, Ulnar artery flap). The other flaps which can be used are Lateral Arm flap, Para scapular flap, Latissimus dorsi flap etc. The skin and underlying tissues are reshaped into a penis and the whole structure is transferred to the pubic area along with the nerves , arteries and veins. The nerves, arteries and veins are anastomosed at the recipient area. The urethra is anastomosed to the native urethra, though it is optional and can be done at a later stage. With meticulous planning and execution, the free flap phalloplasty gives excellent results in the form of a long thick penis which gains erotic sensations over next few months. The nerves lead to sensate penis over a period of 6 to 9 months, though the buried clitoral tissue at the base of penis contributes to erotic sensation starting from early post operative period.
Duration of Procedure: 7-8 hrs. You need to stay for about two to three weeks.
Recovery Time:Back to work in 4-5 weeks. Strenuous activities in 8- 9 weeks.
Longevity of Results:Permanent.
Phalloplasty Stage II
To make the penis erectile and stiff, a penile implant is inserted. The usual requirement is that the penis should be fully sensate. It means it can be performed 6 to 9 months after stage I of phalloplasty as the penis gains sensations till tip during this period.
Duration of Procedure:1 -2 hrs. You may go home on the same day, though if you wish you may stay overnight.
Anesthesia:GA or local with sedation.
Recovery Time:Back to work in 2- 5 days. Strenuous activities in 4- 6 weeks. Sexual activities after 8 week.
Longevity of Results:Permanent .
Frequently Asked Questions
- Do the urinary complications resolve within a few months or may be permanent?
- After inserting implants, are the erection and penetrative sex painful or uncomfortable?
- After the nerve connecting erogenous, is sexual sensation both on the clitoris and on neophallus?
- After surgery is it possible to achieve complete orgasm or is there only some pleasure feeling?
- Will I get the gender change certificate after stage 1 of phalloplasty? Would that certificate be legally valid and easily acceptable for changing my documents?
- Is is better to have vaginectomy pre or post phalloplasty? Can it be performed with Stage 1 or Stage 2?
- When is scrotoplasty done? Is it After stage 2 or along with Stage 2?
- Do you perform glansoplasty as well and if yes can u please share the cost and confirm after how much gap this should have from stage 2?
- Will I be able to stand and urinate after stage 1 or urinary tube connection will be done later, may be around stage 2?
- After all the surgery and treatment can I have a complete male look and can I do an sexual intercourse?