Metoidioplasty vs Phalloplasty: a choice dilemma

<b>Introduction:</b> Metoidioplasty and phalloplasty are one of the most common surgeries among transgender patients, yet they still do not have any specific guidelines, how to perform each method. By synthesizing current evidence, this review seeks to offer clarity on the factors influencing patient choice and the relative advantages and disadvantages of gender affirming surgery. <br><br><b>Aim:</b> The aim of this study is to elucidate the critical factors influencing the choice of surgical method, with a particular focus on the prevalence of common postoperative complications and their impact on sexual satisfaction. <br><br><b>Methods:</b> A total of 22 articles (9 metoidioplasty and 13 phalloplasty surgeries) were collected for the review and analyzed for postoperative urinary tract complications, life satisfaction, and sexual function of the patients. <br><br><b>Results:</b> Nine metoidioplasty articles presented a total of 2718 patients, while 13 articles focused on phalloplasty and provided 1300 cases. <br><br><b>Discussion:</b> It may seem that although phalloplasty results in more male-like looking genitalia, there is no significant difference in general satisfaction with the appearance of the neopenis between phalloplasty and metoidioplasty. Both methods, however, present postoperative complications connected to the urinary tract such as fistulas and strictures. <br><br><b>Conclusions:</b> This review has provided a comparative analysis of metoidioplasty and phalloplasty as 2 principal gender-affirming surgical options for transgender men. While each procedure offers unique benefits and drawbacks, the selection between them should be individualized.