Management of Urologic Complications Following Metoidioplasty and Phalloplasty

Schardein, Jessica; Weinberg, Aaron; Zhao, Lee C.; Nikolavsky, Dmitriy

doi:10.1007/978-3-030-18533-6_11

Cited by 1 publication

(1 citation statement)

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“…The neophallus does not achieve rigidity with blood flow. A penile implant is required if patients desire penile rigidity for intimacy [23][24][25][26].…”

Section: Introduction and Anatomymentioning

confidence: 99%

Gender‐affirming care in urology: emergency care of the gender‐affirming surgical patient—what the primary urologist needs to know

Krakowsky,

Shah,

Nguyen

et al. 2023

BJU International

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ObjectiveTo present a narrative review of fundamental information needed to manage postoperative complications in patients who have undergone genital gender‐affirming surgery (GAS).MethodsA narrative review was performed using the following keywords: ‘gender‐affirming surgery’, ‘complications’, ‘emergency’, ‘postoperative’. Articles were included after being reviewed by two primary authors for relevance. Four clinicians with significant experience providing both primary and ongoing urological care to patients after GAS were involved in article selection and analysis.ResultsThe most common feminising genital GAS performed is a vaginoplasty. The main post‐surgical complications seen by urologists include wound healing complications, voiding dysfunction, postoperative bleeding, vaginal stenosis, acute vaginal prolapse and graft loss, rectovaginal fistula, and urethrovaginal fistula. The most common masculinising genital GAS options include metoidioplasty and phalloplasty. Complications for these surgeries include urethral strictures, urethral fistulae, and urethral diverticula. Penile implants may also accompany phalloplasties and their complications include infection, erosion, migration, and mechanical failure.ConclusionGenital GAS is increasing, yet there are still many barriers that individuals face not only in accessing the surgeries, but in receiving follow‐up care critical for optimal outcomes. Improved education and training programmes would be helpful to identify and manage postoperative complications. Broader cultural level changes are also important to ensure a safe, gender‐inclusive environment for all patients.

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“…The neophallus does not achieve rigidity with blood flow. A penile implant is required if patients desire penile rigidity for intimacy [23][24][25][26].…”

Section: Introduction and Anatomymentioning

confidence: 99%