Male-to-Female (MtoF) gender affirming surgery: Modified surgical approach for the glans reconfiguration in the neoclitoris (M-shape neoclitorolabioplasty)

  • Andrea Cocci | cocci.andrea@gmail.com Careggi Hospital, Department of Urology, University of Florence, Italy.
  • Francesco Rosi Department of Urology, University of Pisa, Italy.
  • Davide Frediani Department of Urology, University of Pisa, Italy.
  • Michele Rizzo Department of Urology, University of Trieste, Italy.
  • Gianmartin Cito Careggi Hospital, Department of Urology, University of Florence, Italy.
  • Carlo Trombetta Department of Urology, University of Trieste, Italy.
  • Francesca Vedovo Department of Urology, University of Trieste, Italy.
  • Simone Grisanti Caroassai Careggi Hospital, Department of Urology, University of Florence, Italy.
  • Augusto Delle Rose Careggi Hospital, Department of Urology, University of Florence, Italy.
  • Valeria Matteucci Department of General Surgery, University of Pisa, Italy.
  • Piero Buccianti Department of General Surgery, University of Pisa, Italy.
  • Cristina Ceccarelli Department of General Surgery, University of Pisa, Italy.
  • Marco Carini Careggi Hospital, Department of Urology, University of Florence, Italy.
  • Andrea Minervini Careggi Hospital, Department of Urology, University of Florence, Italy.
  • Girolamo Morelli Department of Urology, University of Pisa, Italy.

Abstract

Purpose: The aim of this article is to describe our modified surgical technique for the reconfiguration of the glans in the clitoris and the labia minora, known as the “M-shape neoclitorolabioplasty”.
Methods: The glans with all its neurovascular bundle is isolated from the corpora cavernosa, incised in Y-shape mode and spread in order to obtain an M-shape glandular flap. The “belly” of the M-shape glans will constitute the triangular neoclitoris meanwhile the lateral flaps will constitute the labia minora. The inferior apex of the neoclitoris is fixed to the superior apex of the previously spatulated urethra. The two glans flaps are incised transversally to increase their length and sutured to the sides of the spatulated urethra forming the labia minora. Our technique permits to create an aesthetically pleasing neovagina preserving all the glandular erogenous sensitivity.
Results: 94 patients have been treated with our modified technique of male-to-female (MtoF) gender affirming surgery. At median follow-up of 27.57 months, 81 (86.1%) patients reported vaginal intercourse and 78 (82.9%) patients referred presence of erogenous sensitivity during dilatations, intercourse or masturbations. All the glandular tissue is preserved and reconfigured forming the neoclitoris and the labia minora. The M-shape reconfiguration permit to create an aesthetically pleasant neoclitoris.
Conclusions: This technique could be applied safely and easily to patients undergoing gender affirming surgery, allowing the creation of a neovagina with the best possible erogenous sensitivity without losing aesthetical results.

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Published
2019-07-02
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Section
Original Papers - Andrology
Keywords:
Male to female, Gender affirming surgery, Transgender/transsexual
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How to Cite
Cocci, A., Rosi, F., Frediani, D., Rizzo, M., Cito, G., Trombetta, C., Vedovo, F., Grisanti Caroassai, S., Delle Rose, A., Matteucci, V., Buccianti, P., Ceccarelli, C., Carini, M., Minervini, A., & Morelli, G. (2019). Male-to-Female (MtoF) gender affirming surgery: Modified surgical approach for the glans reconfiguration in the neoclitoris (M-shape neoclitorolabioplasty). Archivio Italiano Di Urologia E Andrologia, 91(2). https://doi.org/10.4081/aiua.2019.2.119

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