Sex reassignment surgery for transsexuals

Wroblewski, Peter; Gústafsson, Jónas; Selvaggi, Gennaro

doi:10.1097/01.med.0000436190.80104.56

Cited by 40 publications

(33 citation statements)

References 32 publications

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“…It is important to keep in mind that chest reconstruction surgery is considered an essential step toward improving body image among TM persons [14, 15] whereas TF individuals can achieve visible breast augmentation by hormone therapy alone [16]. The differences in genital reconstruction surgery may be explained by the greater technical difficulties and higher rate of complications associated with female-to-male relative to male-to-female genital reconstruction [17, 18]. …”

Section: Discussionmentioning

confidence: 99%

Agreement between medical records and self-reports: Implications for transgender health research

Gerth

Becerra-Culqui

Bradlyn

et al. 2018

Rev Endocr Metab Disord

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A key priority of transgender health research is the evaluation of long-term effects of gender affirmation treatment. Thus, accurate assessment of treatment receipt is critical. The data for this analysis came from an electronic medical records (EMR) based cohort of transgender individuals. A subset of cohort members were also asked to complete a self-administered survey. Information from the EMR was compared with survey responses to assess the extent of agreement regarding transmasculine (TM)/transfeminine (TF) status, hormone therapy receipt, and type of surgery performed. Logistic regression models were used to assess whether participant characteristics were associated with disagreement between data sources. Agreement between EMR and survey-derived information was high regarding TM/TF status (99%) and hormone therapy receipt (97%). Lower agreement was observed for chest reconstruction surgery (72%) and genital reconstruction surgery (84%). Using survey responses as the "gold standard", both chest and genital reconstruction surgeries had high specificity (95 and 93%, respectively), but the corresponding sensitivities were low (49 and 68%, respectively). A lower proportion of TM had concordant results for chest reconstruction surgery (64% versus 79% for TF) while genital reconstruction surgery concordance was lower among TF (79% versus 89% for TM). For both surgery types, agreement was highest among the youngest participants. Our findings offer assurance that EMR-based data appropriately classify cohort participants with respect to their TM/TF status or hormone therapy receipt. However, current EMR data may not capture the complete history of gender affirmation surgeries. This information is useful in future studies of outcomes related to gender affirming therapy.

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Section: Discussionmentioning

confidence: 99%

Agreement between medical records and self-reports: Implications for transgender health research

Gerth

Becerra-Culqui

Bradlyn

et al. 2018

Rev Endocr Metab Disord

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“…The surgeon must make the patient aware of possible perioperative complications and surgical risks which include anaesthetic problems, significant bleeding and haematoma, pulmonary embolus, deep vein thrombosis, wound breakdown, urethral stenosis, vaginal prolapse, infection and postoperative pain [12][13][14][15]. Although rare, blood transfusions may be necessary.…”

Section: Possible Complicationsmentioning

confidence: 99%

Description of the Baudet Surgical Technique and Introduction of a Systematic Method for Training Surgeons to Perform Male-to-Female Sex Reassignment Surgery

et al. 2015

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“…These procedures are technically difficult and require consideration of patient goals including satisfactory appearance, tactile and erogenous sensation, ability to engage in penetrative sexual intercourse and voiding in a standing position [Wroblewski et al 2013].…”

Section: Introductionmentioning

confidence: 99%

Fasciocutaneous flap reinforcement of ventral onlay buccal mucosa grafts enables neophallus revision urethroplasty

Wilson

Stranix

Khurana

et al. 2016

Therapeutic Advances in Urology

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Background: Urethral strictures or fistulas are common complications after phalloplasty. Neourethral defects pose a difficult reconstructive challenge using standard techniques as there is generally insufficient ventral tissue to support a graft urethroplasty. We report our experience with local fasciocutaneous flaps for support of ventrally-placed buccal mucosal grafts (BMGs) in phalloplasty. Methods: A retrospective review of patients who underwent phalloplasty and subsequently required revision urethroplasty using BMGs between 2011 and 2015 was completed. Techniques, complications, additional procedures, and outcomes were examined. Results: A total of three patients previously underwent phalloplasty with sensate radial forearm free flaps (RFFFs): two female-to-male (FTM) gender reassignment, and one oncologic penectomy. Mean age at revision urethroplasty was 41 years (range 31-47). Indications for surgery were: one meatal stenosis, four urethral strictures (mean length 3.6 ± 2.9 cm), and two urethrocutaneous fistulas. The urethral anastomosis at the base of the neophallus was the predominant location for complications: 3/4 strictures, and 2/2 fistulas. Medial thigh (2) or scrotal (1) fasciocutaneous flaps were used to support the BMG for urethroplasty. One stricture recurrence at 3 years required single-stage ventral BMG urethroplasty supported by a gracilis musculocutaneous flap. All patients were able to void from standing at mean follow up of 8.7 months (range 6-13). A total of two patients (66%) subsequently had successful placement of a penile prosthesis. Conclusions: Our early results indicate that local or regional fasciocutaneous flaps enable ventral placement of BMGs for revision urethroplasty after phalloplasty.

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Sex reassignment surgery for transsexuals

Cited by 40 publications

References 32 publications

Agreement between medical records and self-reports: Implications for transgender health research

Agreement between medical records and self-reports: Implications for transgender health research

Description of the Baudet Surgical Technique and Introduction of a Systematic Method for Training Surgeons to Perform Male-to-Female Sex Reassignment Surgery

Fasciocutaneous flap reinforcement of ventral onlay buccal mucosa grafts enables neophallus revision urethroplasty

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