Metoidioplasty denotes the creation of a neophallus out of the hormonally hypertrophied clitoris. Construction of an esthetically acceptable male-like genitalia while enabling micturition in standing position are the primary goals. Herein, we aim to review the literature regarding masculinizing gender-affirming genital surgery in the form of metoidioplasty, focusing on the steps related to urethral lengthening and reconstruction, and describe the authors’ preferred surgical technique. Clitoral release, division of the urethral plate, native urethral lengthening with anterior vaginal wall flap, and neourethral tubularization using a combination of buccal mucosa graft and labia minora flap(s) seem to provide the best result in terms of urinary outcomes. This is reflected in a greater urethral length, higher probability of standing micturition, and lower incidence of fistula. Urethral complications, which can be encountered in up to 15% of the patients, may necessitate additional procedures. Some of the studies have reported successful penetrative intercourse following metoidioplasty. Case series about different metoidioplasty techniques do not allow head-to-head comparison due to non-standardized reporting and outcome assessment. Metoidioplasty can be offered to transgender men with sufficiently hypertrophied clitoris who wish to avoid a complicated, multistage, flap-based total phalloplasty, or for those individuals considering phalloplasty at a later date.

Metoidioplasty 表示从荷尔蒙肥大的阴蒂中产生新阴茎。主要目标是构建一个美学上可接受的男性样生殖器，同时实现站立排尿。在此，我们旨在回顾关于以甲状膜成形术形式进行男性化性别肯定生殖器手术的文献，重点关注与尿道延长和重建相关的步骤，并描述作者首选的手术技术。阴蒂释放、尿道板分离、用阴道前壁皮瓣延长自然尿道以及使用颊黏膜移植物和小阴唇皮瓣联合进行新尿道管状化似乎在排尿结果方面提供了最好的结果。这反映在更长的尿道长度，更高的站立排尿概率，和较低的瘘管发生率。多达 15% 的患者可能会遇到尿道并发症，可能需要额外的手术。一些研究报告了在甲骨成形术后成功的穿透性交。由于报告和结果评估不规范，有关不同甲状软骨成形术技术的病例系列不允许进行头对头比较。Metoidioplasty 可以提供给那些希望避免复杂的、多阶段的、基于皮瓣的全阴茎成形术的变性男性，或者那些考虑在以后进行阴茎成形术的人。一些研究报告了在甲骨成形术后成功的穿透性交。由于报告和结果评估不规范，有关不同甲状软骨成形术技术的病例系列不允许进行头对头比较。Metoidioplasty 可以提供给那些希望避免复杂的、多阶段的、基于皮瓣的全阴茎成形术的变性男性，或者那些考虑在以后进行阴茎成形术的人。一些研究报告了在甲骨成形术后成功的穿透性交。由于报告和结果评估不规范，有关不同甲状软骨成形术技术的病例系列不允许进行头对头比较。Metoidioplasty 可以提供给那些希望避免复杂的、多阶段的、基于皮瓣的全阴茎成形术的变性男性，或者那些考虑在以后进行阴茎成形术的人。