Carcinoma of the Neovagina After Male-to-Female Reassignment

Fernandes, Hilda; Manolitsas, Tom P.; Jobling, Tom

doi:10.1097/lgt.0b013e3182976219

Cited by 40 publications

(28 citation statements)

References 5 publications

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“…Sexual function was reasonably good in both techniques, but these results could not be compared due to different outcome measures. Although neovaginal carcinoma and diversion colitis have been reported in literature [43–45] and have been feared ever since, they were not observed in the included studies. However, in most studies, follow‐up was not longer than 3 years, and a longer follow‐up would be necessary to assess the true prevalence of these long‐term complications.…”

Section: Discussionmentioning

confidence: 99%

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

241

228

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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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Section: Discussionmentioning

confidence: 99%

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

241

228

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“…The case reports of presumably or potentially HPV-related malignancies in transgender patients who received gender affirmation therapy include anal and neovaginal cancers in transwomen and cervical and vaginal cancers in transmen (17,(31)(32)(33)(34)(35). Of special consideration with respect to neovaginal cancers is the use of heterotopic penile skin, which may be at higher risk for HPV-induced squamous cell carcinoma.…”

Section: Human Papillomavirus Infectionsmentioning

confidence: 99%

Cancer in Transgender People: Evidence and Methodological Considerations

Braun

Nash

Tangpricha

et al. 2017

Epidemiologic Reviews

151

122

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Transgender people comprise a diverse group of individuals whose gender identity or expression differs from that originally assigned to them at birth. Some, but not all, transgender people elect to undergo medical gender affirmation, which may include therapy with cross-sex hormones and/or surgical change of the genitalia and other sex characteristics. As cross-sex hormones administered for the purposes of gender affirmation may be delivered at high doses and over a period of decades, the carcinogenicity of hormonal therapy in transgender people is an area of considerable concern. In addition, concerns about cancer risk in transgender patients have been linked to sexually transmitted infections, increased exposure to well-known risk factors such as smoking and alcohol use, and the lack of adequate access to screening. Several publications have identified cancer as an important priority in transgender health research and called for large-scale studies. The goals of this article are to summarize the evidence on factors that may differentially affect cancer risk in transgender people, assess the relevant cancer surveillance and epidemiologic data available to date, and offer an overview of possible methodological considerations for future studies investigating cancer incidence and mortality in this population.

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“…Multiple cases of condyloma have been reported in transgender women, including one case of condyloma gigantea (Liguori et al, 2004, Wasef et al, 2005, Yang et al, 2009). Consequently, cases of neovaginal carcinoma (both HPV- and non–HPV-associated; Fernandes et al, 2014, Harder et al, 2002) have also been reported. Therefore, an internal examination may be recommended for these individuals, especially with a history of external condylomata.…”

Section: Gender Confirmation Surgerymentioning

confidence: 99%

Dermatologic care of the transgender patient

Ginsberg

2017

International Journal of Women's Dermatology

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Given the complexities of the transitioning process, transgender individuals may face unique dermatologic needs in addition to routine care. Exogenous hormones affect hair and sebum production, gender-confirming surgeries often require dermatologic pre- and postoperative interventions, and postoperative anatomy may show unique presentations of routine skin conditions. Aesthetic techniques that are often used for rejuvenation may have a role in facial feminization and masculinization and unfortunately are too frequently performed by nonmedical personnel with negative consequences. Ultimately, physicians should strive to make their office a more accommodating environment for transgender individuals.

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Carcinoma of the Neovagina After Male-to-Female Reassignment

Cited by 40 publications

References 5 publications

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

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

Cancer in Transgender People: Evidence and Methodological Considerations

Dermatologic care of the transgender patient

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