Principles and outcomes of gender-affirming vaginoplasty

Morrison, Shane D.; Claes, Karel; Morris, Martin P.; Monstrey, Stan; Buncamper, Marlon E.

doi:10.1038/s41585-022-00705-y

Cited by 10 publications

(22 citation statements)

References 144 publications

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“…Penile inversion vaginoplasty is the most commonly performed type of vaginoplasty and includes orchiectomy, shortening of the urethra, creation of the neoclitoris from the glans of the penis, dissection of the neovaginal canal between Denonvillers' fascia and the prostate, and lining the neovagina with a skin graft harvested from the scrotum. 51 Peritoneal flap vaginoplasty involves creating the neovaginal canal from robotically harvested peritoneal flaps and securing these to penile skin, which creates the introitus and distal portion of the vagina. 51 Intestinal vaginoplasty is the least common form of vaginoplasty and involves utilizing either a portion of small or large bowel in creation of the neovaginal canal.…”

Section: Gender-affirming Vaginoplastymentioning

confidence: 99%

“…51 Peritoneal flap vaginoplasty involves creating the neovaginal canal from robotically harvested peritoneal flaps and securing these to penile skin, which creates the introitus and distal portion of the vagina. 51 Intestinal vaginoplasty is the least common form of vaginoplasty and involves utilizing either a portion of small or large bowel in creation of the neovaginal canal. 51 Complications following any approach include hematoma, wound dehiscence, issues with urine stream, vaginal stenosis, and rectovaginal fistula (RVF).…”

Section: Gender-affirming Vaginoplastymentioning

confidence: 99%

“…51 Intestinal vaginoplasty is the least common form of vaginoplasty and involves utilizing either a portion of small or large bowel in creation of the neovaginal canal. 51 Complications following any approach include hematoma, wound dehiscence, issues with urine stream, vaginal stenosis, and rectovaginal fistula (RVF). 51…”

Section: Gender-affirming Vaginoplastymentioning

confidence: 99%

“…51 Complications following any approach include hematoma, wound dehiscence, issues with urine stream, vaginal stenosis, and rectovaginal fistula (RVF). 51…”

Section: Gender-affirming Vaginoplastymentioning

confidence: 99%

“…The former is most commonly composed of keratinized squamous epithelium, derived from local flaps and skin grafts. 51 Additionally, scar tissue makes it more difficult to identify the correct planes, limits the tissue available for repair, and increases the overall friability of the tissue.…”

Section: Management Of Rnvf In Transfeminine Individualsmentioning

confidence: 99%

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Considerations for the Treatment of Sexual and Gender Minority Individuals in Colon and Rectal Surgery

Roblee,

Jacobson,

Lane

et al. 2024

Clin Colon Rectal Surg

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Sexual and gender minorities (SGMs) experience critical barriers to health care access and have unique health care needs that are often overlooked. Given the rise in individuals identifying as lesbian, gay, bisexual, transgender, and queer, colorectal surgeons are likely to care for increasing numbers of such individuals. Here, we discuss key barriers to health care access and research among SGM populations and outline approaches to address these barriers in clinical practice. We also highlight two specific topics relevant to SGM populations that colorectal surgeons should be familiar with: current approaches to anal cancer screening among men who have sex with men, and transgender individuals, as well as the management of recto-neovaginal fistula in transfeminine individuals.

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Section: Gender-affirming Vaginoplastymentioning

confidence: 99%

Section: Gender-affirming Vaginoplastymentioning

confidence: 99%

Section: Gender-affirming Vaginoplastymentioning

confidence: 99%

“…51 Complications following any approach include hematoma, wound dehiscence, issues with urine stream, vaginal stenosis, and rectovaginal fistula (RVF). 51…”

Section: Gender-affirming Vaginoplastymentioning

confidence: 99%

Section: Management Of Rnvf In Transfeminine Individualsmentioning

confidence: 99%

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Considerations for the Treatment of Sexual and Gender Minority Individuals in Colon and Rectal Surgery

Roblee,

Jacobson,

Lane

et al. 2024

Clin Colon Rectal Surg

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Gynecologic Oncology Needs for Trans-Masculine and Trans Feminine Persons

Rimel,

Murphy

2024

Curr Obstet Gynecol Rep

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Purpose of the Review Persons with gender identity that is not congruent with their sex assigned at birth have unique needs in relationship to gynecologic malignancy screening and treatment. Providers of gynecologic oncology care require knowledge of these specific concerns and inclusive practices to avoid under screening and offer evidence-based treatments. This review seeks to collate data on the most common clinical situations gynecologic oncology providers encounter. Recent Findings Transmasculine persons who have a cervix need access to appropriate prevention and screening for cervical cancer but may face obstacles to obtaining this care. Transfeminine persons may develop HPV infection of the neovagina but cancer development rare and prevention is largely unknown. Abnormal uterine bleeding in transmasculine persons either taking gender affirming hormone therapy or not can present a diagnostic challenge which requires careful consideration to rule out malignancy. Concerns about testosterone use and the relationship of androgen receptor to ovarian cancer progression have been raised but conclusive data is lacking. There are no effective strategies for ovarian cancer screening and unnecessary exams should be avoided. Summary Large population based studies are needed to develop evidence based HPV screening guidelines that align with reproductive organ inventories, rather than gender or simply sex assigned at birth. HPV vaccination, utilization of HPV self swab in those for whom pelvic examination is dysphoric and careful evaluation of neovaginal tissue are first steps in reducing HPV related cancer burden. In addition, providers need to carefully evaluate abnormal uterine bleeding in transmasculine persons in gender inclusive ways to adequately detect endometrial pathology. Androgen receptor presence on ovarian cancer remains a biologic concern for transmasculine persons on gender affirming hormone therapy but risk of ovarian cancer appears small. Further long term studies of testosterone hormone therapy in this population are needed.

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