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The Munawar & Norfolk Procedures

GlansplastyGlansplasty is the name of the procedure to construct the glans penis, which is the sensitive and bulbous structure at the tip of the penis. The glans—also commonly referred to as the "head of the penis"— is sometimes fully or partially covered by the foreskin, except in men who have been fully circumcised. The glans penis is anatomically homologous to the clitoral glans.

Glansplasty is a procedure that helps create an anatomically correct penis. It may be done at stage 1 or later (to ensure there is ample blood supply), depending on phalloplasty procedure and surgeon preference. Depending on the surgeon, the glans may or may not incorporate the urethral opening. Many men also opt to have the glans tattooed for more natural looking coloring.

glans penis

In Munawar's procedure, a circumferential skin flap is raised distally about 5 mm in width and folded back on itself to create a coronal ridge.

The Norfolk procedure refers to the interposition of a skin graft in Munawar's procedure. It creates a more normal neoglans as assessed by patients themselves and by surgeons. Split-thickness skin graft (SSG) produces a more normal-looking coronal sulcus than full-thickness skin graft (FTSG) in the Norfolk procedure.

Other glansplasty procedures include the Gottleib design, which uses labial tissue for improved pigmentation of the glans, and the Horton technique, which involves raising a circumferentially deepithelializing skin flap at the level of the proposed coronal ridge, which is then rolled-up, suturing the free edge of the flap to its own base; thus, forming a ridge. 


Also see: Journal articles about Glansplasty