Long-Term Outcomes of Rectosigmoid Neocolporrhaphy in Male-to-Female Gender Reassignment Surgery

Morrison, Shane D.; Satterwhite, Thomas; Grant, David W.; Kirby, Johanna; Laub, Donald R.; VanMaasdam, Judy

doi:10.1097/prs.0000000000001459

Cited by 77 publications

(59 citation statements)

References 6 publications

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“…Although initially pioneered in the 1900s, it was not until decades later, in 1974, that the intestinal vaginoplasty technique was utilized in male‐to‐female transgender vaginoplasty by Markland and Hastings. The substantial morbidity associated with this method was responsible for the delay (Morrison et al ). Nongenital skin flaps, described by Cairns and De Villiers, in 1980, were typically grafted from the medial thigh (Selvaggi et al ).…”

Section: Evolution Of Male‐to Female (Mtf) Transgender Genital Reconsmentioning

confidence: 99%

“…Inadequate lubrication of the neovagina during intercourse is also a disadvantage to consider during the selection process. Although the donor site of the harvested skin graft is also at a higher risk for scaring (Selvaggi et al ), the use of perineal split‐thickness or full‐thickness grafts can mitigate this issue (Morrison et al ).…”

Section: Current Techniques In Male‐to‐female (Mtf) Transgender Genitmentioning

confidence: 99%

“…It is superior to skin grafts as it has a lesser risk of contracture (Selvaggi et al ). It is not without flaw, however, requiring supplemental lubrication and an ongoing commitment to vaginal dilation to aid in the prevention of vaginal stenosis (Selvaggi et al ; Morrison et al ). Notably, this method often requires additional skin grafts to provide tissue for a neovagina of suitable size (Selvaggi et al ; Morrison et al ).…”

Section: Current Techniques In Male‐to‐female (Mtf) Transgender Genitmentioning

confidence: 99%

“…Ideally, it is used in staged surgical procedures and also in secondary vaginoplasties. The associated advantages are the harvesting of a self‐lubricating tissue with adequate dimensions and a lower susceptibility toward graft contractions (Morrison et al ; Selvaggi et al ; Sutcliffe et al ). Due to the relatively invasive nature of this method, morbidity of the intra‐abdominal harvest is probable.…”

Section: Current Techniques In Male‐to‐female (Mtf) Transgender Genitmentioning

confidence: 99%

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The evolution of transgender surgery

et al. 2018

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An estimated 1.4% of the population worldwide has been diagnosed with Gender Dysphoria, as defined by the Diagnostic and Statistical Manual of Mental Disorders. Gender reassignment, which holistically encompasses psychotherapy, hormonal therapy and genital and nongenital surgeries, is considered the most effective treatment for transgender nonconforming patients afflicted with gender dysphoria. Little research is currently available identifying the psychosocial needs of the transgender population and their access to preventative and primary care during this transitioning process. This article presents an overview of the evolution and current approaches to genital surgical procedures available for both male-to-female, as well as female-to-male gender-affirmation surgeries. Clin. Anat. 31:878-886, 2018. © 2018 Wiley Periodicals, Inc.

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Section: Evolution Of Male‐to Female (Mtf) Transgender Genital Reconsmentioning

confidence: 99%

Section: Current Techniques In Male‐to‐female (Mtf) Transgender Genitmentioning

confidence: 99%

Section: Current Techniques In Male‐to‐female (Mtf) Transgender Genitmentioning

confidence: 99%

Section: Current Techniques In Male‐to‐female (Mtf) Transgender Genitmentioning

confidence: 99%

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The evolution of transgender surgery

et al. 2018

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“…Of these techniques, rectosigmoid vaginoplasty is a frequently used surgical method in male-tofemale sex reassignment surgery [4]. This procedure has the following advantages over other conventional surgical procedures: a more natural appearance of the neovagina, increased vault length, erogenous sensibility, adequate lubrication from the rectosigmoid flap, and less potential for contraction and vaginal dilator use [5]. Nonetheless, stenosis/stricture of the rectosigmoid neovagina still has a high incidence, occurring in 22.5% of patients [5].…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of a completely obstructed rectosigmoid vaginal introitus in a transgender woman

Lee

Yoon

Ahn

2020

Arch Aesthetic Plast Surg

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Rectosigmoid vaginoplasty is a frequently used surgical method in male-to-female sex reassignment surgery. However, severe side effects, such as sepsis, may occur owing to stricture, mucorrhea, and rectovaginal fistula. Herein, we present the case of a 29-yearold patient who underwent complete reconstruction of an obstructed rectosigmoid vaginal orifice. The patient had undergone male-to-female sex reassignment surgery with rectosigmoid vaginoplasty 8 years previously. The vaginal introitus was completely obstructed, and mucous secretions of the rectum remained in the blind pouch. Therefore, she developed several complications, including panperitonitis, sepsis, and repeated obstruction. We performed complete resection of the scar and reconstructed the orifice of the neovagina using a pudendal thigh island flap. The patient's lifethreatening condition subsided with the successful release of the vaginal orifice. Vaginal orifice stricture is a frequent complication of rectosigmoid vaginoplasty. A pudendal thigh flap can be used to effectively and safely release this stricture and reconstruct the neo-orifice of the rectosigmoid vagina without recurrence.

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Implementation of Patient-Reported Outcome Measures for Gender-Affirming Care Worldwide

et al. 2023

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ImportanceGender-affirming care is a key clinical area that can benefit from implementation of patient-reported outcome measures (PROMs). Identifying barriers to and enablers of PROM implementation is needed to develop an evidence-based implementation strategy.ObjectiveTo identify (1) PROMs previously implemented for gender-affirming care and constructs measured, (2) how patients completed PROMs and how results were reported and used, and (3) barriers to and enablers of PROM implementation.Evidence ReviewIn this systematic review, PubMed, Embase, MEDLINE, PsycINFO, CINAHL, and Web of Science were searched from inception to October 25, 2021, and updated on December 16, 2022. Gray literature was searched through gray literature database, online search engine, and targeted website searching. Inclusion criteria were (1) original articles of (2) a formally developed PROM or ad hoc instrument administered for gender-affirming care to (3) patients accessing gender-affirming care. The Critical Appraisal Skills Programme tool was used to evaluate quality of included studies. This review was registered on PROSPERO (CRD42021233080).FindingsIn total, 286 studies were included, representing 85 395 transgender and nonbinary patients from more than 30 countries. A total of 205 different PROMs were used in gender-affirming care. No studies described using an implementation science theory, model, or framework to support PROM deployment. Key barriers to PROM implementation included issues with evidence strength and quality of the PROM, engaging participants, and PROM complexity. Key enablers of PROM implementation included using PROMs validated for gender-affirming care, implementing PROMs able to be deployed online or in person, implementing PROMs that are shorter and reduce patient burden, engaging key stakeholders and participants as part of developing an implementation plan, and organizational climate.Conclusions and RelevanceIn this systematic review of barriers to and enablers of PROM implementation in gender-affirming care, PROM implementation was inconsistent and did not follow evidence-based approaches in implementation science. There was also a lack of patient input in creating implementation strategies, suggesting a need for patient-centered approaches to PROM implementation. Frameworks created from these results can be used to develop evidence-based PROM implementation initiatives for gender-affirming care and have potential generalizability for other clinical areas interested in implementing PROMs.

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Long-Term Outcomes of Rectosigmoid Neocolporrhaphy in Male-to-Female Gender Reassignment Surgery

Abstract: Therapeutic, IV.

Cited by 77 publications

References 6 publications

The evolution of transgender surgery

The evolution of transgender surgery

Reconstruction of a completely obstructed rectosigmoid vaginal introitus in a transgender woman

Implementation of Patient-Reported Outcome Measures for Gender-Affirming Care Worldwide

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