Gender reassignment surgery - a 13 year review of surgical outcomes

Neto, R. Rossi; Hintz, F.; Krege, Susanne; Rübben, H.; Dorp, F. vom

doi:10.1590/s1677-55382012000100014

Cited by 104 publications

(84 citation statements)

References 31 publications

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“…Neovaginal stricture was reported in six studies [21,22,26,28,30,31]. Stricture of the neovaginal introitus was present in 84 of 674 studied patients (12%, range 4.2–15%).…”

Section: Resultsmentioning

confidence: 92%

“…[21], who used a urethral flap for the anterior neovaginal wall. Genital pain was present in 9% [28] and 3% [31] in patient groups of, respectively, 232 and 332 MtF patients.…”

Section: Resultsmentioning

confidence: 97%

“…Partial necrosis of the neovagina ranged from 2.7% to 4.2% [22,23,31] and clitoral necrosis ranged from 1% to 3% [27,28,30]. Namba et al.…”

Section: Resultsmentioning

confidence: 98%

“…In four studies [10,21,22,29] with a total of 917 MtF patients, nine cases of rectovaginal fistula were reported, with a mean percentage of 1% (range 0.8–17%). The prevalence of neovaginal prolapse was 1–2% in four studies [23,27,30,31]. All surgeons in these studies had fixated the neovagina with sutures to the surrounding connective tissue during initial surgery; fixation to the sacrospinous ligament was not reported.…”

Section: Resultsmentioning

confidence: 99%

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Outcome of Vaginoplasty in Male-to-Female Transgenders: A Systematic Review of Surgical Techniques

Horbach,

Bouman,

Smit

et al. 2015

The Journal of Sexual Medicine

237

209

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Introduction Gender reassignment surgery is the keystone of the treatment of transgender patients. For male-to-female transgenders, this involves the creation of a neovagina. Many surgical methods for vaginoplasty have been opted. The penile skin inversion technique is the method of choice for most gender surgeons. However, the optimal surgical technique for vaginoplasty in transgender women has not yet been identified, as outcomes of the different techniques have never been compared. Aim With this systematic review, we aim to give a detailed overview of the published outcomes of all currently available techniques for vaginoplasty in male-to-female transgenders. Methods A PubMed and EMBASE search for relevant publications (1995–present), which provided data on the outcome of techniques for vaginoplasty in male-to-female transgender patients. Main Outcome Measures Main outcome measures are complications, neovaginal depth and width, sexual function, patient satisfaction, and improvement in quality of life (QoL). Results Twenty-six studies satisfied the inclusion criteria. The majority of these studies were retrospective case series of low to intermediate quality. Outcome of the penile skin inversion technique was reported in 1,461 patients, bowel vaginoplasty in 102 patients. Neovaginal stenosis was the most frequent complication in both techniques. Sexual function and patient satisfaction were overall acceptable, but many different outcome measures were used. QoL was only reported in one study. Comparison between techniques was difficult due to the lack of standardization. Conclusions The penile skin inversion technique is the most researched surgical procedure. Outcome of bowel vaginoplasty has been reported less frequently but does not seem to be inferior. The available literature is heterogeneous in patient groups, surgical procedure, outcome measurement tools, and follow-up. Standardized protocols and prospective study designs are mandatory for correct interpretation and comparability of data.

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“…Neovaginal stricture was reported in six studies [21,22,26,28,30,31]. Stricture of the neovaginal introitus was present in 84 of 674 studied patients (12%, range 4.2–15%).…”

Section: Resultsmentioning

confidence: 92%

“…[21], who used a urethral flap for the anterior neovaginal wall. Genital pain was present in 9% [28] and 3% [31] in patient groups of, respectively, 232 and 332 MtF patients.…”

Section: Resultsmentioning

confidence: 97%

“…Partial necrosis of the neovagina ranged from 2.7% to 4.2% [22,23,31] and clitoral necrosis ranged from 1% to 3% [27,28,30]. Namba et al.…”

Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Outcome of Vaginoplasty in Male-to-Female Transgenders: A Systematic Review of Surgical Techniques

Horbach,

Bouman,

Smit

et al. 2015

The Journal of Sexual Medicine

237

209

View full text Add to dashboard Cite

show abstract

“…Outcomes research on other transition related interventions, including speech therapy, are scattered throughout the literature [51,52,53]. Studies exist on patient satisfaction with surgical outcomes [54,55], but not on satisfaction with hormonal treatment outcomes separate from overall surveys of access to care or satisfaction with overall health care services in a given setting. Studies eliciting patient identified objective outcomes and priorities are themselves lacking.…”

Section: Research To Datementioning

confidence: 99%

Priorities for transgender medical and healthcare research

Feldman

Brown

Deutsch

et al. 2016

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

117

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Purpose of Review Transgender individuals experience unique health disparities but are the subject of little focused health research. This manuscript reviews current literature on transgender medical and mental health outcomes and proposes research priorities to address knowledge gaps. Recent Findings Published research in transgender health care consists primarily of case reports, retrospective and cross-sectional studies, involving largely European settings. Challenges to US-based transgender health research include a diverse population where no single center has sufficient patient base to conduct clinical research with statistical rigor. Treatment regimens are heterogeneous and warrant study for best practices. Current research suggests increased mortality and depression in transgender individuals not receiving optimal care, and possibly a modest increase in cardiovascular risk related to hormone therapy. Current evidence does not support concerns for hormone related malignancy risk. Summary The priorities for transgender medical outcomes research should be to determine health disparities and co-morbid health conditions over the life span, along with the effects of mental health, medical, and surgical interventions on morbidity and mortality. Specific outcomes of interest based on frequency in the literature, potential severity of outcome, and patient-centered interest, include affective disorders, cardiovascular disease, malignancies, fertility, and time-dose related responses of specific interventions.

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