For many female-to-male (FtM) transgender persons, construction of a neophallus is a crucial culminating step in the gender transition.
Approximately six weeks after the first stage flap prelami-nation, creation of the neophallus was performed by transferring the prelaminated construct as a radial forearm free osteocutaneous flap for inset over the denuded clitoris and lengthened urethra.
In a voiding trial, the patient was able to successfully void in the standing position through this neophallus.
The neophallus is to be kept dry, and pressure is avoided on it; elevation is encouraged while in bed or resting.
Donor tissue used for construction of the neophallus is most frequently harvested from the radial forearm or the anterolateral thigh depending on patient preferences for aesthetic outcome of the phallus and donor site morbidity.
The vaginal tissue may then be used to create a urethral length sufficient to carry urine through the neophallus created by a metoidioplasty or a phalloplasty (Bowman & Goldberg, 2006).
Metoidioplasty, also called metaidoioplasty in the literature, involves the creation of a neophallus using the hormonally enlarged existing clitoral tissue, which functions as the glans penis and is composed of erectile tissue analogous to penile tissue (Bowman & Goldberg, 2006; Sutcliffe et al.
Phalloplasty is the creation of a neophallus and is a very complex surgical procedure done using a range of different methods requiring free tissue grafts.
The creation of the neophallus generally uses a flap of tissue from the forearm rolled into a tube to create the urethra, which is then rolled within a larger flap that includes fat and skin to make a "tube within a tube," resulting in an adult-sized phallus that transmits urine.