Metoidioplasty Procedures

Not all FTM patients are interested in getting a phalloplasty that would enable them to have penetrative intercourse. Some of them focus instead on being able to urinate standing up.

Long-term continuous testosterone treatment provokes the enlargement of the clitoris—which is then described as “hypertrophied,” and often nicknamed as a “dicklit.” Metoidioplasty surgery involves releasing the hypertrophied clitoris by cutting the suspensory ligament. The urethra is then lengthened, with grafts from the labia minora, the vaginal mucosa and/or the buccal mucosa used to create its inner walls.

It’s possible to create a scrotum by sealing off the labia majora and inserting testicle implants. Most of the time, a hysterectomy is also performed and the vagina is sealed off.

Having benefited from a metoidioplasty, the patient may later consider having the more major surgery of phalloplasty, to obtain an adult-sized penis with the capacity for functional sexual intercourse (with the help of implants).

The size of the clitoris transformed through metoidioplasty does not usually allow for functional sexual penetration. A metoidioplasty implant is placed not to enable erections but to prevent the tissues from retracting and becoming necrotic. This implant consists of two malleable rods inserted inside the corpora cavernosa of the clitoris, just as penile implants are inserted into the penile corpora cavernosa of biological men.


ZSI is the first company to design such implants, and implantations have already begun in France.

ZSI is the only European manufacturer of artificial urinary sphincters and of malleable and inflatable penile implants, as solutions for male urological problems (incontinence), sexual complications (Erectile Dysfunction), and gender identity procedures (prostheses for trans men and women).