Phalloplasty is the main treatment for
gender dysphoria disorder. It is difficult to ascertain if staging of
phalloplasty influences the rate of complications. We aim to describe and compare the rates of complication between single versus two-stage
phalloplasty for transgender female-to-male patients. PubMed, Ovid Medline, EMBASE and SCOPUS databases were queried for studies reporting complications of female-to-male transgender patients who underwent
phalloplasty. The keywords "
phalloplasty", "female to male", "outcome", "complication" and synonyms in different combinations were used for the search. Only studies that could identify whether phallic shaft creation was performed in a single or two-stage procedure were included. From a total of 336 articles, 20 met the inclusion criteria. Sixteen studies reported complications associated with a single-stage
phalloplasty and seven studies identified complications after a two-stage procedure. The most common complications found for both groups of staging were
fistula,
stricture and total/partial flap
necrosis. Patients who underwent two-stage
phalloplasty had higher complication rates (partial or total flap
necrosis and
fistulas), compared with the single-stage procedure (P<0.05). In conclusion, this systematic review identified the impact of staging in the rate of complications related to
phalloplasty for transgender female-to-male patients; a two-stage
phalloplasty has a higher rate of complications.