Genital Gender Affirming Surgery

Li, Virginia Y; Demzik, Alysen; Snyder, Liem; Ogunleye, Adeyemi A; Wang, Annmarie; Figler, Bradley D.

doi:10.1177/00031348221109479

Cited by 8 publications

(3 citation statements)

References 32 publications

(23 reference statements)

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“…According to bioethical aspects, good female genitalia were created as a primary goal in all cases, while microdissection and remnant removal did not jeopardize the outcome of gender-affirming vaginoplasty. Contrary to reported cases of penile transplantation, we found a lack of available donor penile skin that is usually used for standard genderaffirming vaginoplasty, leaving denuded corpora cavernosa as an unsuitable tissue for transplantation [18,27]. We do not consider that as a disadvantage.…”

Section: Discussioncontrasting

confidence: 86%

“…The dorsal segment of the glans supported with nerve and blood elements is reshaped, making a sensitive clitoris. Additionally, the urethra is mobilized and spatulated, and the bulbar part is used for the creation of the female urethral orifice while the distal part is joined with the glans clitoris, creating the vulvo-vestibular complex [18]. Our experience of more than 30 years in this field raised ideas on how to use removed remnants as possible tissue for live-donor penile transplantation [14,19,20].…”

Section: Discussionmentioning

confidence: 99%

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Penile Microdissection: A Live Donor Feasibility Study in Feminizing Gender-Affirming Surgery

Pusica,

Stojanovic,

Bencic

et al. 2023

Life

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Femininizing gender affirmation surgery includes the creation of external female genitalia such as a new clitoris, labia, and vagina with removal of the glans and urethral remnants and full corpora cavernosa. We evaluated the possibility of using preserved cavernosal bodies with glans and urethral remnants for potential live-donor penile transplantation. Between March 2021 and February 2023, penile microvascular dissection followed by gender-affirming vaginoplasty was performed in 41 patients aged 18 to 57 years (mean 30.5 years). The mean follow-up was 15 months (ranging from 6 to 26 months). The removed penile entities were properly measured. The corpora cavernosa were completely preserved in all cases; the length of remaining anterior urethra ranged from 12.70 cm to 16.40 cm, while the mean glans remnant volume was 85.37% of the total volume. All patients reported satisfactory results after gender-affirming vaginoplasty. Microvascular penile dissection in gender-affirming vaginoplasty is simple and safe, suggesting a good possibility of using the full corpora cavernosa, glans, and anterior urethra remnants for live-donor penile transplantation.

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Section: Discussioncontrasting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Penile Microdissection: A Live Donor Feasibility Study in Feminizing Gender-Affirming Surgery

Pusica,

Stojanovic,

Bencic

et al. 2023

Life

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“…In a systematic review and meta-analysis that examined the outcome and complications of 3388 transgender females after penile inversion vaginoplasty, the mean prevalence of reported urinary complications ranged from 5.0%–11.9% with the most common symptoms being splayed stream (11.7%), meatal stenosis (6.9%), and irritative symptoms (frequency, urgency, nocturia) (11.5%) ( 124 ). In trans men, phalloplasty and metoidioplasty are the two most common genital surgeries ( 81 , 125 ). Metoidioplasty is reported to have a complication rate of 10%–37% with postvoid dribble and/or a spraying stream (33%) and urethrocutaneous fistulas (5%–23%) being the most common ( 81 ).…”

Section: Medical Care For Transgender Pain Patientsmentioning

confidence: 99%

Pain mechanisms in the transgender individual: a review

Anger,

Case,

Baranowski

et al. 2024

Front. Pain Res.

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Specific AimProvide an overview of the literature addressing major areas pertinent to pain in transgender persons and to identify areas of primary relevance for future research.MethodsA team of scholars that have previously published on different areas of related research met periodically though zoom conferencing between April 2021 and February 2023 to discuss relevant literature with the goal of providing an overview on the incidence, phenotype, and mechanisms of pain in transgender patients. Review sections were written after gathering information from systematic literature searches of published or publicly available electronic literature to be compiled for publication as part of a topical series on gender and pain in the Frontiers in Pain Research.ResultsWhile transgender individuals represent a significant and increasingly visible component of the population, many researchers and clinicians are not well informed about the diversity in gender identity, physiology, hormonal status, and gender-affirming medical procedures utilized by transgender and other gender diverse patients. Transgender and cisgender people present with many of the same medical concerns, but research and treatment of these medical needs must reflect an appreciation of how differences in sex, gender, gender-affirming medical procedures, and minoritized status impact pain.ConclusionsWhile significant advances have occurred in our appreciation of pain, the review indicates the need to support more targeted research on treatment and prevention of pain in transgender individuals. This is particularly relevant both for gender-affirming medical interventions and related medical care. Of particular importance is the need for large long-term follow-up studies to ascertain best practices for such procedures. A multi-disciplinary approach with personalized interventions is of particular importance to move forward.

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