The meatus of the original urethra in women is positioned lower than that of men and far from the tip of the glans. Before performing the new penis, the original female urethra has to lengthen further and move it up to the level of the clitoris to connect with the new urethra.
There are 2 procedures to perform urethral enlargement:
Mucosa vagina flap technique
In the procedure a total vaginectomy is performed and a vagina flap is created to make the expansion of mucous tubes as well as the lengthening of the urethra, both procedures are performed at the same time. The urethral catheter is maintained 3 weeks after the operation. The urethra needs dilation for 6 months or until the passage of total phalloplasty.
- More reliable and less urethral complications.
- The procedure is performed separately from the step of total phalloplasty. The urethra catheter needs to be maintained 3 weeks after operation.
Internal lip technique and local flap
In case the vaginectomy was performed at the same surgical time as the hysterectomy & total oophorectomy, the internal labia and the mucosa around the urethral orifice can also be used for urethral enlargement. The procedure can be performed at the same time as total phalloplasty and scrotum plasty.
- Once the total vaginectomy and hysterectomy & oophorectomy have been performed in the same step, the urethral catheter is maintained a few days after the operation. 6 months later, the patient may undergo total phalloplasty.
- Urethral enlargement is performed at the same time as total phalloplasty, the risk of complications.