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The Scientific World Journal
Volume 2014 (2014), Article ID 437378, 7 pages
Clinical Study

The Role of Clitoral Anatomy in Female to Male Sex Reassignment Surgery

1University Children's Hospital, Tirsova 10, 11000 Belgrade, Serbia
2School of Medicine, University of Belgrade, 11000 Belgrade, Serbia

Received 10 February 2014; Accepted 20 March 2014; Published 10 April 2014

Academic Editors: M. Bizic, M. L. Djordjevic, and F. E. Kuehhas

Copyright © 2014 Vojkan Vukadinovic et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction. Controversies on clitoral anatomy and its role in female sexual function still make clitoral reconstructive surgery very challenging. We evaluated the role of clitoral anatomic features in female to male sex reassignment surgery. Material and Methods. The study included 97 female transsexuals, aged from 18 to 41 years, who underwent single stage metoidioplasty between March 2008 and January 2013. The operative technique involved vaginectomy, the release of clitoral ligaments and urethral plate, urethroplasty by combining buccal mucosa graft and genital flaps, and scrotoplasty with insertion of testicle prostheses. Postoperative questionnaire was used to evaluate aesthetic, functional, and sexual outcome. Results. The mean followup was 30 months. The mean length of the neophallus was 7 cm, compared to mean preoperative length of the hypertrophied clitoris of 3.3 cm. Complications occurred in 27.84% of all patients, related mostly to urethroplasty. Voiding while standing was achieved in all cases. None of the patients had problems in sexual arousal, masturbation, or orgasms. Conclusion. Accurate knowledge of the clitoral anatomy, physiology, and neurovascular supply is crucial for a successful outcome of female to male sex reassignment surgery. Our approach appears to ensure overall satisfaction and high quality of sexual life.