Metoidioplasty in Norway: A 13-year Experience from a National Center

Background:. Genital surgery is often considered the final step in surgical gender-affirming treatment. Metoidioplasty is a variant where the enlarged clitoris is lengthened and straightened. The technique has several advantages but is not without complications. We evaluated the surgical outcomes af...

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Main Authors: Henriette Pisani Sundhagen, MD, Anne Wæhre, PhD, MD, Kim Alexander Tønseth, PhD, MD
Format: Article
Language:English
Published: Wolters Kluwer 2024-11-01
Series:Plastic and Reconstructive Surgery, Global Open
Online Access:http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006307
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author Henriette Pisani Sundhagen, MD
Anne Wæhre, PhD, MD
Kim Alexander Tønseth, PhD, MD
author_facet Henriette Pisani Sundhagen, MD
Anne Wæhre, PhD, MD
Kim Alexander Tønseth, PhD, MD
author_sort Henriette Pisani Sundhagen, MD
collection DOAJ
description Background:. Genital surgery is often considered the final step in surgical gender-affirming treatment. Metoidioplasty is a variant where the enlarged clitoris is lengthened and straightened. The technique has several advantages but is not without complications. We evaluated the surgical outcomes after metoidioplasty from our national center from 2007 to 2020. Methods:. All patients who had undergone the metoidioplasty procedure at Oslo University Hospital from January 1, 2007, to December 31, 2020, were identified by the Local Quality Register of Gender Incongruence. Demographic, clinical, and surgical variables were recorded. Statistical analysis was carried out with SPSS. Results:. A total of 84 patients were identified. The median age at the time of surgery was 27.5 years. Of 84 patients, 48 (57.1%) experienced some kind of complication after the surgery, with an average of 1.7 complications. Complications related to the urethroplasty were the most common, with strictures occurring in 19 (22.6%) patients and urethral fistulas occurring in 11 (13.1%) patients. Forty-one patients (48.8%) needed 1 or more secondary procedures. After the management of strictures and fistulas, a secondary testis implant correction was the most frequent revision procedure performed in 38.1% (32) of patients. With increasing body mass index, the risk of complications and of undergoing secondary procedures also increased significantly (P = 0.045 and 0.019, respectively). Conclusions:. Metoidioplasty is an operation with a relatively high complication rate, mainly related to urethroplasty. There is an urgent need for future research with a focus on quality of life and long-term follow-up.
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spelling doaj-art-37f9dc08eb3241dc9b97e4df275ce03b2024-11-26T08:02:36ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742024-11-011211e630710.1097/GOX.0000000000006307202411000-00041Metoidioplasty in Norway: A 13-year Experience from a National CenterHenriette Pisani Sundhagen, MD0Anne Wæhre, PhD, MD1Kim Alexander Tønseth, PhD, MD2From the * Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway‡ Department of Child and Adolescent Psychiatry, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, NorwayFrom the * Department of Plastic and Reconstructive Surgery, Oslo University Hospital, Oslo, NorwayBackground:. Genital surgery is often considered the final step in surgical gender-affirming treatment. Metoidioplasty is a variant where the enlarged clitoris is lengthened and straightened. The technique has several advantages but is not without complications. We evaluated the surgical outcomes after metoidioplasty from our national center from 2007 to 2020. Methods:. All patients who had undergone the metoidioplasty procedure at Oslo University Hospital from January 1, 2007, to December 31, 2020, were identified by the Local Quality Register of Gender Incongruence. Demographic, clinical, and surgical variables were recorded. Statistical analysis was carried out with SPSS. Results:. A total of 84 patients were identified. The median age at the time of surgery was 27.5 years. Of 84 patients, 48 (57.1%) experienced some kind of complication after the surgery, with an average of 1.7 complications. Complications related to the urethroplasty were the most common, with strictures occurring in 19 (22.6%) patients and urethral fistulas occurring in 11 (13.1%) patients. Forty-one patients (48.8%) needed 1 or more secondary procedures. After the management of strictures and fistulas, a secondary testis implant correction was the most frequent revision procedure performed in 38.1% (32) of patients. With increasing body mass index, the risk of complications and of undergoing secondary procedures also increased significantly (P = 0.045 and 0.019, respectively). Conclusions:. Metoidioplasty is an operation with a relatively high complication rate, mainly related to urethroplasty. There is an urgent need for future research with a focus on quality of life and long-term follow-up.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006307
spellingShingle Henriette Pisani Sundhagen, MD
Anne Wæhre, PhD, MD
Kim Alexander Tønseth, PhD, MD
Metoidioplasty in Norway: A 13-year Experience from a National Center
Plastic and Reconstructive Surgery, Global Open
title Metoidioplasty in Norway: A 13-year Experience from a National Center
title_full Metoidioplasty in Norway: A 13-year Experience from a National Center
title_fullStr Metoidioplasty in Norway: A 13-year Experience from a National Center
title_full_unstemmed Metoidioplasty in Norway: A 13-year Experience from a National Center
title_short Metoidioplasty in Norway: A 13-year Experience from a National Center
title_sort metoidioplasty in norway a 13 year experience from a national center
url http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006307
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