Total phalloplasty includes creation of neophallus from an extragenital tissue, large enough to enable insertion of penile prosthesis and penetration during sexual intercourse. Urethroplasty, which enables voiding in standing position, is performed later on, in separate stages. Metoidioplasty presents creation of small phallus, from hormonally enlarged clitoris, which enables voiding in standing position, but without possibility for sexual intercourse. We evaluated advantages of combining phalloplasty and metoidioplasty as one stage procedure.