A phalloplasty is a surgical procedure where a penis is created. A phalloplasty is a multi-staged procedure that may include a variety of different procedures, including creation of the penis, lengthening the urethra so you are able to stand to pee, creating the tip (glans) of the penis, creation of the scrotum, removal of the vagina, and placing erectile and testicular implants. It is important to note that each staged surgical plan is unique to each patient and may or may not include some/all of the above procedures.
Will the penis be functional?
Penis functionality is determined by the surgical plan. If it is important for you to pee out of the tip of your penis, then urethral lengthening is indicated. If sensation is most important, we will focus on a donor site with good nerve innervation. If penetrative sex is most important, and you would like to maintain an erection, then an erectile prosthetic is indicated for staging.
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What kind of sensation and feeling can I expect?
Sensation recovery varies by patient. Nerve regeneration can begin as early as 3 weeks post-operatively or may take longer in some patients. Sometimes sensation can take up to a year or longer. We cannot guarantee return of nerve sensation. It typically begins as a shooting/spark feeling as your nerves regenerate and build stronger connections. As time goes on, the tingling feeling begins to subside.
How does the donor site affect sensation after surgery?
Different donor sites have different nerve qualities. The arm donor site has the greatest number of nerves available for nerve hook-up and is best if your main goal is sensation. The leg donor site has greater variability, but tends to have less available nerves. The nerve associated with the MLD flap is a motor nerve, meaning there will likely be no sensation on the phallus.