While we hope all of our patients have a smooth healing process from their initial genital surgeries, we know this is not always the case. Complications can occur with any surgery, and some people may want or need additional surgeries to resolve these complications. This page will describe some of the more common revision surgeries that may take place after phalloplasty and metoidioplasty. Please make sure to tell your surgeon if you are experiencing any issues during or after your initial healing.
Some patients experience issues with urination after surgery. This can include inability to urinate, urine spraying, frequent urination, urinary retention, etc. If you experience any of these issues, please speak with your surgeon to figure out if a surgical revision is a potential solution.
A cystoscopy is a procedure which uses a scope to look at the inside of the urethra. This is not a revision surgery on its own, but it can help identify what may be occuring. Undergoing a cystoscopy generally does not require going under anesthesia.
A stricture is a narrowing of the urethra caused by a buildup of scar tissue. If a stricture negatively affects urination, it can be revised by cutting out the scar tissue buildup and replacing it with a graft from the inside of the cheek, also called a buccal mucosa graft. The inside of the cheek, from where the graft is taken, is stitched together and heals without affecting the appearance of the face.
A fistula is an opening which allows urine to exit from the body where it shouldn’t be. Fistulas can occur along the penile shaft and on or underneath the scrotum. Often, fistulas heal on their own. When they do not, they may require a revision surgery to close the fistula.
After phalloplasty, some patients may have a penis that is too long or girthy for their preferences. In this case, some of the tissue and fat from the penis can be removed in a revision surgery to result in a smaller penis.
An erectile device can be implanted after phalloplasty. The erectile device can also be removed after it is implanted. This may be required or preferred for a number of reasons – infection, malfunction of the device, pain, no longer wanting it, etc. An additional surgery is needed to remove the erectile device.