Combined hysterectomy and mastectomy surgery for transgender patients in an integrated health care setting

Cizek, Stephanie; Nguyen, Nancy; Lyon, Liisa; Zaritsky, Eve; Weiss, Erica

doi:10.1080/15532739.2017.1359725

Cited by 6 publications

(18 citation statements)

References 11 publications

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“…Smaller cohorts were described by Cizek et al. ( 2017 ) (n = 25) and Stojanovic et al. (2017) (n = 79), who reported fewer complications associated with the mastectomy (4% and 7.6% respectively), while similar complication rates after a combined procedure were reported by Hager et al.…”

Section: Discussionmentioning

confidence: 58%

“…Only minor adverse events were described in these studies, and, if reported, described complications were mainly hematomas (Hager et al, 2019;Stojanovic et al, 2017). Cizek et al stated that no complications could be attributed to the fact that the two procedures were combined in a single incident (Cizek et al, 2017). Concerning the order of the two procedures, Ott et al advised to perform the TLH ± BSO before mastectomy, because they observed a slightly (but not significantly) higher complication rate when performed in a reverse order (Ott et al, 2010).…”

Section: Introductionmentioning

confidence: 96%

“…To date, only five studies reviewed the outcomes of this combined procedure, four in trans men (Cizek et al, 2017;Hager et al, 2019;Ott et al, 2010;Stojanovic et al, 2017) and one in cis women (Sinkey et al, 2016). All authors concluded that the combined procedure is safe, feasible, timeand cost-saving and valuable (Cizek et al, 2017;Hager et al, 2019;Ott et al, 2010;Sinkey et al, 2016;Stojanovic et al, 2017). Only minor adverse events were described in these studies, and, if reported, described complications were mainly hematomas (Hager et al, 2019;Stojanovic et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

“…Combined surgery could be of value for trans men for several reasons: patients require general anesthesia only once, consume shorter hospital stays, have a reduced recovery time and therefore experience lower levels of stress and anxiety (Hager et al., 2019 ; Kaiser et al., 2011 ; Mitchell, 2003 ). To date, only five studies reviewed the outcomes of this combined procedure, four in trans men (Cizek et al., 2017 ; Hager et al., 2019 ; Ott et al., 2010 ; Stojanovic et al., 2017) and one in cis women (Sinkey et al., 2016 ). All authors concluded that the combined procedure is safe, feasible, time- and cost-saving and valuable (Cizek et al., 2017 ; Hager et al., 2019 ; Ott et al., 2010 ; Sinkey et al., 2016 ; Stojanovic et al., 2017).…”

Section: Introductionmentioning

confidence: 99%

“…Cizek et al. stated that no complications could be attributed to the fact that the two procedures were combined in a single incident (Cizek et al., 2017 ). Concerning the order of the two procedures, Ott et al.…”

Section: Introductionmentioning

confidence: 99%

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Combining total laparoscopic hysterectomy and bilateral salpingo-oophorectomy with subcutaneous mastectomy in trans men: The effect on safety outcomes

Elfering

Grift

Bouman

et al. 2020

International Journal of Transgender Health

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Background: Masculinizing mastectomy is the most requested gender affirming surgery (GAS) in trans men, followed by genital GAS. Mastectomy and total laparoscopic hysterectomy, with or without bilateral salpingo-oophorectomy (TLH ± BSO), can both be performed in one single operation session. However, data on complication rates of the combined procedure is scarce and no consensus exists on the preferred order of procedures. Aims: To compare safety outcomes between mastectomy performed in a single procedure with those when performed in a combined procedure and assess whether the order of procedures matters when they are combined. Methods: A retrospective chart review was performed of trans men who underwent masculinizing mastectomy with or without TLH ± BSO in a combined session. The effects of the surgical procedure on complication and reoperation rate of the chest were assessed using logistic regression. Results: In total, 480 trans men were included in the study. Of these, 212 patients underwent the combined procedure. The gynecological procedure was performed first in 152 (71.7%) patients. In the total sample, postoperative hematoma of the chest occurred in 11.3%; 16% in the combined versus 7.5% in the single mastectomy group (p ¼ 0.001). Reoperations due to hematoma of the chest were performed in 7.5% of all patients; 10.8% in the combined versus 4.9% in the single mastectomy group (p ¼ 0.017). The order of procedures in the combined group had no significant effect on postoperative hematoma of the chest (p ¼ 0.856), and reoperations (p ¼ 0.689). Conclusion: Combining masculinizing mastectomy with TLH ± BSO in one session was associated with significantly more hematoma and reoperations compared with separately performing mastectomy. This increased risk of complications after a combined procedure should be considered when deciding on surgical options. The order of procedures in a combined procedure did not have an effect on safety outcomes.

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Section: Discussionmentioning

confidence: 58%