Dr. Miroslav Djordjevic is one of the best known surgeons performing metoidioplasty and has contributed significantly to the development of the procedure. As he is often referred to simply as Dr. Miro that’s what I will call him for the remainder of this post.
Dr. Miro is an Assistant Professor of Surgery at the Belgrade University Medical School and a Urology Specialist. He previously worked as part of a team with Dr. Sava Perovic, another well known SRS surgeon. Together, they’ve authored many academic papers on SRS procedures, including this excellent journal article in 2003, Metoidioplasty: A Variant of Phalloplasty in female transsexuals. All trans men curious about metoidioplasty will want to read this.
Ethan posted a detailed backgrounder and account of his consultation with Dr. Miro on his website, so I’ll avoid duplication and simply suggest that you check it out.
Dr. Miro was very quick to reply to my emails and provided plenty of helpful detail with his answers.
Questions and Answers
What meta procedure do you offer for trans men?
Metoidioplasty with urethral extension and scrotoplasty.
Vaginectomy is usually done at the same time but is not required.
What is your current pricing (2008) for this procedure?
University Hospital: €9000 EUR plus the €780 EUR for the testicle prostheses
St. Medica: €10,000 EUR plus the €780 EUR for the testicle prostheses
At today’s currency exchange rates, this works out to:
( 1 = 0.619613 EUR)
(1 = 0.786475 EUR)
These prices include all anesthesiologist and facility fees (and do not include vaginectomy, per my request.)
Is an in-person consultation required prior to booking surgery?
A consultation is required, but it can be done via email.
What kind of waiting list do you have?
[No answer provided, will ask again and update this info.]
Do you perform this in one or two surgeries?
Where do you perform these procedures?
University Hospital or St. Medica in Belgrade, Serbia.
Do you require patients to stop taking testosterone prior to surgery?
Yes, patient must stop taking testosterone 2-3 weeks before surgery.
How long is the hospital stay?
2-4 days in hospital, then stay in the area for 10-14 days.
What tissue is used for the urethral extension?
We use a buccal mucosa graft for urethral reconstruction because it is very good material that is similar to urethral mucosa. We also use the part of anterior vaginal flap in reconstruction of the bulbar part of the urethra to prevent the possibility of having the fistula at that point.
How long is the suprapubic catheter left in?
The suprapubic catheter is left for 4-5 weeks after the surgery.
[This is a big difference from Dr. Bowers (within a week) and Dr. McGinn (10-14 days) and deserves further explanation. From Ethan’s site:
They have had a much lower complication rate when leaving the suprapubic catheter in for at least 4 weeks, as compared to 2-3 weeks. With the suprapubic catheter, the only thing that prevents you from urinating out of the new urethra is voluntary holding of urine (ie. you could urinate out of your new urethra from the very beginning, but they recommend waiting at least 4 weeks to allow it to heal). At the end of 4 weeks, you can begin urinating out of the new urethra. The suprapubic catheter should remain in place for the first 2-3 days while you are using the new urethra. If everything goes well using the new urethra, you can simply pull the suprapubic catheter out yourself at home, and the hole in the bladder will contractually close immediately. They recommend you take antibiotics to prevent any bladder infections.]
What are the common complications with these procedures?
Urethral fistula occurs in about 25% in patients when vaginectomy is not performed. This is because of the strength of the urine stream at the point of anastomosis of native and neourethra.
How many times have you performed metoidioplasty with urethral extension?
[I didn’t ask this question directly because it’s well-known that Dr. Miro has performed more than 100 metoidioplasties with urethral extension and scrotoplasty.]
Please note: This information is provided for information purposes only and in no way should it serve as a replacement for your own research and consultations. My intent is not to find a “winner”, but to figure out which surgeon I am best suited to. We each have unique requirements and criteria, so please don’t go on my word. At the same time, there are plenty of questions that surgeons have to answer over and over, so hopefully this series will cut down on some of that repetition.
- Part 1: Surgeons I am not considering
- Part 2: Dr. Marci Bowers
- Part 3: Dr. Christine McGinn
- Part 4: Dr. Miroslav Djordjevic
- Part 5: Dr. Toby Meltzer
Also see: Metoidioplasty Surgery Guide