Neovaginal Construction in Vaginal Aplasia and Sex-Reassignment Surgery

Siemssen, Peter A.; Matzen, Steen Henrik

doi:10.3109/02844319709010504

Cited by 23 publications

(8 citation statements)

References 5 publications

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“…An outcome review of different techniques documented the presence of vaginal stenosis in 6-15% using penoscrotal skin flaps (17)(18)(19), 5-55% with penile skin inversion only (20-24) and 8-45% using free-skin grafts (25)(26)(27)(28). In our group of patients, lost of vaginal depth occurred in 7.5% of the cases along with vaginal (12%) and introitus (14.5%) strictures.…”

Section: Discussionmentioning

confidence: 97%

559 Gender reassignment surgery – a 13 year review of surgical outcomes

Rossi¹,

Hintz²,

Krege³

et al. 2013

European Urology Supplements

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Section: Discussionmentioning

confidence: 97%

559 Gender reassignment surgery – a 13 year review of surgical outcomes

Rossi¹,

Hintz²,

Krege³

et al. 2013

European Urology Supplements

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“…However, there are published vaginal stenosis rates of 5–66%. Analysed by technique vaginal stenosis was documented in 6–15% using penoscrotal skin flaps [2,3,5], 5–55% with inversion of penile skin only [4–15] and 8–45% using free‐skin grafts [16–19].…”

Section: Discussionmentioning

confidence: 99%

Feminizing genitoplasty in adult transsexuals: early and long‐term surgical results

et al. 2007

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penectomy, urethroplasty and labiaplasty, 207 (93%) had formation of a neoclitoris, and 202 (91%) had a skin-lined neovagina. The median (range) age was 41 (19-76) years. The median hospital stay was 10 (6-21) days. A record of the first outpatient visit was available in 197 (84.5%) cases. The median time to follow up was 56 (8-351) days. Over all, 82.2% had an adequate vaginal depth, with a median depth of 13 (5-15) cm and 6.1% had developed vaginal stenosis. Three (1.7%) patients had had a vaginal prolapse, two (1.1%) had a degree of vaginal skin flap necrosis and one (0.6%) was troubled with vaginal hair growth. In 86.3% of the patients the neoclitorizes were sensitive. There was urethral stenosis in 18.3% of the patients and 5.6% complained of spraying of urine. Minor corrective urethral surgery was undertaken in 36 patients including 42 urethral dilatations, and eight meatotomies were performed. At the first clinic visit 174 (88.3%) patients were 'happy', 13 (6.6%) were 'unhappy' and 10 (5.1%) made no comment. Of the 233 patients, we successfully contacted 70 (30%). All had had penectomy and labioplasty, 64 (91%) had a clitoroplasty and 62 (89%) a neovagina. The median age was 43 (19-76) years and the median follow up was 36 (9-96) months. Overall, 63 (98%) had a sensate neoclitoris, with 31 (48%) able to achieve orgasm; nine (14%) were hypersensitive. Vaginal depth was considered adequate by 38 (61%) and 14 (23%) had or were having regular intercourse. Vaginal hair growth troubled 18 (29%), four (6%) had a vaginal prolapse and two (3%) had vaginal necrosis. Urinary problems were reported by 19 (27%) patients, of these 18 (26%) required revision surgery, 14 (20%) complained of urinary spraying, 18 (26%) had an upward directed stream and 16 (23%) had urethral stenosis. The patients deemed the cosmetic result acceptable in 53 (76%) cases and 56 (80%) said the surgery met with their expectations. CONCLUSIONThis is largest series of early results after male to female FG. Complications are common after this complex surgery and long-term follow-up is difficult, as patients tend to relocate at the start of their 'new life' after FG. There were good overall cosmetic and functional results, with a sustained high patient satisfaction. KEYWORDS OBJECTIVETo examine the early and late surgical outcomes of feminizing genitoplasty (FG) in adult transsexuals in a UK single surgeon practice over a 10-year period. PATIENTS AND METHODSComputerized and manual databases were searched over the period 1994-2004 to identify patients who had undergone male to female FG. Case-notes were retrieved and analysed to identify epidemiological data, the number and type of perioperative problems, early results at outpatient review, late occurring problems and patient satisfaction. A telephone questionnaire was then conducted targeting all FG patients in our series. The questions were directed at identifying surgical complications, outcome and patient satisfaction. RESULTSIn all, 233 case-notes were identified and 222 (95%) were retrieved....

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“…In a group of 11 MtF transgenders, Siemssen and Matzen [13] used FTG of penile skin, STG, or a combination of both. Overall, vaginal stenosis was present in 45% of patients (n = 5) but with STG alone in 100%.…”

Section: Skin Graftsmentioning

confidence: 99%

“…For MtF transgenders, the core surgical procedures are orchidectomy, penectomy, clitoroplasty, labiaplasty, and creation of the neovagina, together often referred to as “(neo)vaginoplasty.” Other common surgical procedures for the establishment of a feminine aesthetic appearance are breast augmentation, facial feminization surgery, permanent hair removal, lipoplasty, and thyroid chondroplasty [9,10]. In the fields of gynecology, urology, and reconstructive plastic surgery, many surgical techniques for vaginal (re)construction have been described [2,10–13]. Not only MtF transgenders but also biological women with disorders of sexual development (such as Mayer‐Rokitansky‐Kustner or intersex disorders) and those who underwent vaginectomy after malignancy or trauma are possible candidates for vaginoplasty.…”

Section: Introductionmentioning

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

245

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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Neovaginal Construction in Vaginal Aplasia and Sex-Reassignment Surgery

Cited by 23 publications

References 5 publications

559 Gender reassignment surgery – a 13 year review of surgical outcomes

559 Gender reassignment surgery – a 13 year review of surgical outcomes

Feminizing genitoplasty in adult transsexuals: early and long‐term surgical results

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

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