- Vaginal and/or vulva preservation: Several patients request that the vaginal canal and/or parts of the vulva be kept in-tact with the creation of a penis. Vaginal preservations are only possible when the original urethra is kept intact; this means a patient could only urinate while sitting down or with the use of an assistive device, as opposed to being able to pee out of the tip of their penis. Likewise, the clitoris/natal penis and labia can be kept intact so long as the patient does not wish to have a urethral lengthening..
- Urethral lengthening: If a patient wishes to get a urethral lengthening to pee out of the tip of their penis, they must have a vaginectomy performed before or at the same time as this procedure. This is done to reduce the chance of urinary complications. Patients who wish to have a vaginal preserving phalloplasty cannot undergo a urethral lengthening. .
- Scrotum and/or testicles: If a patient would like a scrotum, a scrotoplasty can be done 6 months before or after the construction of the penis. If a patient would like the appearance of testicles, after three months of healing, scrotal tissue expanders can be inserted. 4-5 months after that, silicone testicular implants can be inserted.
- Sterilization Procedures: Patients who wish to have a urethral lengthening procedure will need to have a hysterectomy done at least 8-12 weeks prior. An oophorectomy is optional. Dr. Ley does not perform these procedures.
- Erectile device: A year after the penis is constructed through a phalloplasty, an erectile device can be inserted to facilitate its use for penetrative sex. The insertion of the device would increase the girth of the penis. Even without an erectile device being surgically inserted, patients can still have penetrative sex with their phalloplasty results using a silicone erectile sleeve or other assistive device.
- You can read more about these additional procedures and their recovery protocols here.
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