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Operative staging of a phalloplasty

We split the surgery into manageable stages so that the operations are not too complicated and patients’ bodies can get a rest in between each stage, which is important.
  • STAGE 1: Formation of the phallus and/or neo-urethra in phallus
  • STAGE 2: Glans sculpting, scrotoplasty and connect neo-urethra to bladder
  • STAGE 3: Erectile and testicular prosthesis
If a patient wants a neo-urethra (urinary passage through the phallus) then this has to be completed before the penile prosthesis is implanted. If there is an unsatisfactory result or complication from any stage then this is normally corrected before moving on to the next stage. 

It is important to realise that there may sometimes be more than one operation involved at each stage and there should normally be at least three months in between each operation.  Patients having all three stages can therefore take 12-18 months to complete their surgery even if there are no complications requiring extra admissions.  It is not uncommon for the entire process to require two to three years (or even longer if there are problems fitting in the surgery around the requirements of employment, holidays etc.).

Patients should also be aware that we will not list people for surgery until they are ready to proceed.  This means for example that we will not list someone for surgery in the expectation that they will have reached their target weight by the time of surgery.  Similarly we do not list people for the next stage of surgery until they have completely recovered from the previous stage.  This is partly because of difficulties predicting how quickly a wound will heal and also because the final outcome of one stage may affect the details of the surgery required at the next procedure.
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