Pedicled Peritoneal Flap Vaginoplasty in Male-to-Female Gender Affirmation Surgery: A Case Report

Suwajo, Poonpissamai; Ratanalert, Worapon; Sooksatian, Krerkrit; Uerpairojkit, Ketchada; Dusitanond, Navipa; Chaovanalikit, Thiti; Jindarak, Sirachai; Udomsawaengsup, Suthep

doi:10.1097/spv.0000000000000888

Cited by 5 publications

(2 citation statements)

References 21 publications

(25 reference statements)

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“…Recently, Suwajo et al reported a case of successful laparoscopic pedicled peritoneal vaginoplasty for male-to-female gender reaffirmation surgery with a good neovaginal surface at 9 months after surgery and, histologically, the neovaginal lining was squamous epithelium. 13 In their study, the flap tubing was made extracorporeally. In our study, the peritoneal flap was taken laparoscopically in all cases, flap tubing was made intracorporeal in one case and extracorporeal in other four cases.…”

Section: Discussionmentioning

confidence: 99%

Male-to-Female Gender Affirmation Vaginoplasty via Laparoscopic Pedicled Peritoneal Flap—An Initial Experience

Sachan

Jain

Sharma

et al. 2022

Indian J Plast Surg

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Objective The objective of this study was to describe our early experience with laparoscopic pedicled peritoneal flap in patients undergoing male-to-female gender affirmation vaginoplasty. Methods This is a case series of five patients who underwent laparoscopic pedicled peritoneal flap vaginoplasty for gender reaffirmation from October 2020 to July 2021. The clinical and functional outcomes were recorded. Results Two patients underwent the surgery as a primary procedure, and three patients underwent surgery as a secondary deepening procedure after failed penile skin inversion. There were no complications after surgery, and the median length of hospital stay was 3 days. No patient developed vaginal stenosis in 6-month follow-up period, and the median vaginal depth was 6 inches with a healthy vaginal surface. Conclusion Laparoscopic pedicled peritoneal flap can be considered as a first choice in gender affirmation surgeries for patients with inadequate penoscrotal skin or failed penile skin inversion.

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Section: Discussionmentioning

confidence: 99%

Male-to-Female Gender Affirmation Vaginoplasty via Laparoscopic Pedicled Peritoneal Flap—An Initial Experience

Sachan

Jain

Sharma

et al. 2022

Indian J Plast Surg

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“…Proposed advantages include the lack of a suture line at the apex, inclusion of a substantive urachus, and exclusion of the rectum [32]. Finally, a pedicled peritoneal flap based on the deep inferior epigastric artery has been described that is first externalized through a groin incision, then delivered into the neovagina extra-peritoneally through a separate perineal incision [33]. No studies have directly compared these differing peritoneal flap techniques.…”

Section: Peritoneummentioning

confidence: 99%

Tissue Options for Construction of the Neovaginal Canal in Gender-Affirming Vaginoplasty

Bene,

Ferrin,

et al. 2024

JCM

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Gender-affirming vaginoplasty (GAV) comprises the construction of a vulva and a neovaginal canal. Although technical nuances of vulvar construction vary between surgeons, vulvar construction is always performed using the homologous penile and scrotal tissues to construct the corresponding vulvar structures. Therefore, the main differentiating factor across gender-affirming vaginoplasty techniques is the tissue that is utilized to construct the neovaginal canal. These tissue types vary markedly in their availability, histology, and ease of harvest and have different advantages and disadvantages to their use as neovaginal lining. In this narrative review, the authors provide a comprehensive overview of the tissue types and associated operative approaches used for construction of the neovagina in GAV. Tissue choice is guided by several factors, such as histological similarity to natal vaginal mucosa, tissue availability, lubrication potential, additional donor site morbidity, and the specific goals of each patient. Skin is used to construct the neovagina in most cases with a combination of pedicled penile skin flaps and scrotal and extra-genital skin grafts. However, skin alternatives such as peritoneum and intestine are increasing in use. Peritoneum and intestine are emerging as options for primary vaginoplasty in cases of limited genital skin or revision vaginoplasty procedures. The increasing number of gender-affirming vaginoplasty procedures performed and the changing patient demographics from factors such as pubertal suppression have resulted in rapidly evolving indications for the use of these differing vaginoplasty techniques. This review sheds light on the use of less frequently utilized tissue types described for construction of the neovaginal canal, including mucosal tissues such as urethral and buccal mucosa, the tunica vaginalis, and dermal matrix allografts and xenografts. Although the body of evidence for each vaginoplasty technique is growing, there is a need for large prospective comparison studies of outcomes between these techniques and the tissue types used to line the neovaginal canal to better define indications and limitations.

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The use of peritoneum in female genital gender-affirming surgery: A systematic review

Tondu,

Allepot,

Youkharibache

et al. 2024

Annales de Chirurgie Plastique Esthétique

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Pedicled Peritoneal Flap Vaginoplasty in Male-to-Female Gender Affirmation Surgery: A Case Report

Cited by 5 publications

References 21 publications

Male-to-Female Gender Affirmation Vaginoplasty via Laparoscopic Pedicled Peritoneal Flap—An Initial Experience

Male-to-Female Gender Affirmation Vaginoplasty via Laparoscopic Pedicled Peritoneal Flap—An Initial Experience

Tissue Options for Construction of the Neovaginal Canal in Gender-Affirming Vaginoplasty

The use of peritoneum in female genital gender-affirming surgery: A systematic review

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