Category Archives: Metoidioplasty

Considering female to male bottom surgery, how is the vagina removed?

Dear Dr. Reed, Considering female to male bottom surgery, how is the vagina removed?  What else is required?  Lisa

Dear Lisa,

In order to prepare for female to male bottom surgery which may be either a metoidioplasty and a phalloplasty, you will need to have your ovaries and uterus removed, usually laparoscopically. Removing the vagina is fraught with unnecessary complication in that it is close to adjacent structures such as the rectum, bladder and urethra.  We recommend colpocleisis which is closure of the vagina.

Colpocleisis is accomplished by cauterizing the inner or mucosal lining of the vaginal, placing in a drain (temporary) and closing the space with a helical suture.

Colpocleisis is a procedure to close the vagina without removing the muscular wall.  Although a few techniques have been described, our approach is the cauterize the inner lining (mucosa) of the vagina and place in a few helical or spiral sutures of absorbable material around a central drain bringing the cavity together.  The drain is ultimately removed once adhesions are well formed.

This should be proceeded by a total hysterectomy, removal of the uterus and cuff of vagina (done by others).  At that time your tubes and ovaries are also removed. Allow several months following bilateral salpingo-oophorectomy with laparoscopically assisted hysterectomy before proceeding to colpocleisis.   An advantage of the laparoscopic approach is minimization of any abdominal incision.

Vaginal closure will provide a floor for the scrotum and subsequent insertion of testicular implants.  Also when the vagina is closed there is more support for healing at the base of the urethra.  You will undoubtedly want urethral extension for a stand to void result.  Closure of the vagina reduces (but does not completely preclude) the likelihood fistula formation or urinary leakage through small opening that has not healed.

Occasionally a patient may wish to preserve bisexual capabilities.  Please give careful consideration and confer with your therapists and surgeons.


Harold M. Reed, M.D.
The Reed Centre for Transgender Surgery | Dr. Harold Reed | Miami

Metoidioplasty after picture

Phalloplasty done by another transgender surgeon.  Revision to provide glans refinement and penile implant insertion done by Dr. Reed


Many questions on Metoidioplasty, Testicle Implants, and Colpocleisis

Good morning Byron, Answering your thoughtful questions regardiong metoidioplasty in the order posed…. 1. The price for metoidioplasty The surgery, Anesthetic, use of facility and aftercare you quoted is $12,500 US dollars correct? Yes. 2.  So does this include some accommodation for patients that just had the surgery? Because the likelihood is I will be there…Continue Reading

Would like a long metoidioplasty, after all I’m a guy

Dear Dr. Reed, For reasons of economy I have decided for the moment not to have a phalloplasty but to have a metoidio[plasty as I have learned that a metoidioplasty can be converted to a phalloplasty later on.  Is this true?  And what can I do to get the longest possible metoidioplasty? Gerald Dear Gerald, Yes,…Continue Reading

Metoidioplasty FTM

Dr. Reed,  When you do a metoidioplasty will I be able to urinate standing. Sammy Dear Sammy, Than you for viewing the many photos of our metoidioplasty results on   The steps to metoidioplasty are ideally laparoscopic salpingo-oophorectomy, and assisted vaginal total hysterectomy.   Wait about 3 months for healing, then colpocleisis or closure of the…Continue Reading

Transgender Male to Female

Transgender people are more prevalent than you might imagine because many are exceedingly passable and assimilate easily into society  both on the job and with respect to bathroom privileges. Naturally most seek above and below the waist conformation. The Reed Centre in Miami has been providing an outpatient resource for transgender surgery since 2002.  Photos…Continue Reading

FTM transsexual wants testicle implants

Dr. Reed, I am an FTM seeking testicular implants. Raymond Dear Raymond, Please see photographic examples on our web-site:  also see photographic examples   2/1 and 4/1  We us  a very natural feeling implant that comes in a variety of sizes so as not to dwarf your phallus. We offer affordable transgender pricing.  These…Continue Reading

Metoidioplasty or FTM bottom surgery

Metoidioplasty or Metaidoioplasty (phallic clitoral enlargement, stand to void) The procedure confers the advantage of minimal surgery with preservation of natural sensation and erectile function. Donor site forearm scars avoided. Overweight patients may achieve greater length with pubic lipectomy which will recess the body surface line. In this procedure the clitoral hood is lifted and…Continue Reading

FTM metoidioplasty

Dear Dr. Reed, How does a metoidioplasty differ from a phalloplasty. Gerri, Dear Gerri, A metoidioplasty is an operation which results in a juvenile sized penis when the clitoris which has enlarged secondary o t4stosterone taken usually intramuscularly results in clitoral hypertrophy. This can be augmented by applying a compound similar to testosterone to the…Continue Reading

What is metoidioplasty?

For construction of a penis, there are 2 approaches: metoidioplasty and (full-scale) phalloplasty.   Metoidioplasty is the simpler and least expensive of the two.  Metoidioplasty is taken from the Greek words, meta meaning toward oidion meaning male organs, and plasty to form.  A metoidioplasty is based surgical release of a clitoris which has been primed on…Continue Reading