Urethral lengthening, also known as metoidioplasty or phalloplasty, is a surgical procedure that some trans men may choose as part of their female-to-male (FTM) transition. This procedure aims to create a neourethra, lengthening the urethra to allow for urination through the newly constructed penis.

The specific techniques and procedures used for urethral lengthening can vary depending on the surgeon, the chosen surgical method (metoidioplasty or phalloplasty), and individual preferences and anatomical considerations.

Here are some general aspects of urethral lengthening in FTM transition:

Metoidioplasty: In metoidioplasty, the procedure uses existing genital tissue to construct a neophallus. The clitoral hood is usually used to create the neourethra, which allows for the lengthening of the urethra. The neophallus is usually smaller in size and retains some sensitivity due to the hormonal effects of testosterone.

Phalloplasty: In phalloplasty, the procedure involves using various techniques to create a neophallus, which is typically larger in size. Urethral lengthening is achieved by using tissue grafts, such as skin or other tissues, to create a neourethra. The graft is connected to the bladder to allow for urination through the neophallus.

It’s important to note that urethral lengthening surgeries are complex procedures and carry potential risks and complications, including urinary complications and the need for multiple surgeries. The decision to undergo urethral lengthening is highly personal and should be made in consultation with experienced surgeons who specialize in transgender surgeries. They can provide detailed information, discuss the available options, and assess an individual’s specific needs and goals.

It’s crucial to have thorough discussions with healthcare professionals and fully understand the potential risks, benefits, and expected outcomes of urethral lengthening before making a decision. Pre-operative evaluations, as well as post-operative care and follow-up, are essential for a successful outcome.