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Jae A Puckett, Peter Cleary, Kinton Rossman, Michael E Newcomb, Brian Mustanski
Gender-affirming care, including hormone therapy, "top" (e.g., chest reconstruction surgery) and "bottom" (e.g., vaginoplasty, phalloplasty, metoidioplasty, etc.) surgeries, and puberty blockers, is an efficacious treatment of gender dysphoria for transgender and gender nonconforming (TGNC) individuals. However, many TGNC people encounter significant barriers in accessing gender-affirming care, which we detail via results from on online study. Participants included 256 TGNC individuals (78...
March 2018: Sexuality Research & Social Policy
Joshua D Roth, Jessica T Casey, Benjamin M Whittam, William E Bennett, Konrad M Szymanski, Mark P Cain, Richard C Rink
OBJECTIVES: To analyze nationwide information on the timing of surgical procedures, cost of surgery, hospital length of stay following surgery and surgical complications of female genital restoration surgery (FGRS) in females with congenital adrenal hyperplasia (CAH). METHODS: We used the Pediatric Health Information System database to identify patients with CAH who underwent their initial FGRS in 2004-2014. These patients were identified by an ICD-9 diagnosis code for adrenogenital disorders (255...
March 2, 2018: Urology
Zoltán Fekete, Szilvia Körösi, Gábor Németh
INTRODUCTION: The prevalence of pelvic organ prolapse (POP) with aging is escalating alarmingly, and now becoming a growing epidemic among the elderly. Synthetic transvaginal mesh (TVM) has been employed with increasing popularity in the treatment of POP until the end of the last decade. After the U.S. Drug and Food Administration (FDA) warnings in the years 2008 and 2011, the number of vaginal mesh operations has decreased dramatically. AIM: The aim of the study was to evaluate and compare the anti-POP effectivity, the anti-stress incontinence (anti-SUI) efficacy, and the late (36 months) post-operative complications of the anterior vaginoplasty and the TVM operations...
March 2018: Orvosi Hetilap
Oscar J Manrique, Kian Adabi, Jorys Martinez-Jorge, Pedro Ciudad, Fabio Nicoli, Kidakorn Kiranantawat
INTRODUCTION: There is an increased need for evidence-based practices in male-to-female (MtF) transgender vaginoplasty. Although there are a multitude of surgical techniques, there is a paucity of data comparing these procedures. A systematic review of retrospective studies on the outcomes of MtF vaginoplasty was conducted to minimize surgical complications and improve patient outcomes for transgender patients. METHODS: Applying the Preferred Reporting Items for Systematic Review and Meta-Analysis, a comprehensive search of several databases from 1985 to November 7, 2017, was conducted...
February 28, 2018: Annals of Plastic Surgery
Mehrsa Jalalizadeh, S Abbas Shobeiri
Male-to-female gender reassignment surgery may lead to unsatisfactory vaginal length. No standard approaches are established to treat these patients. We present a case of vaginoplasty using the laparoscopic Davydov technique performed on a male-to-female transgender patient. Our case provides a novel approach to treating this rare condition and introduces Davydov procedure as a potentially effective and safe treatment. Preoperative endovaginal and endoanal 3-dimensional ultrasounds and a pelvic magnetic resonance imaging of the case are presented to provide details of this patient's unique anatomy...
February 15, 2018: Female Pelvic Medicine & Reconstructive Surgery
Miriam Hadj-Moussa, Dana A Ohl, William M Kuzon
INTRODUCTION: For many patients with gender dysphoria, gender-confirmation surgery (GCS) helps align their physical characteristics with their gender identity and is a fundamental element of comprehensive treatment. This article is the 2nd in a 3-part series about the treatment of gender dysphoria. Non-operative management was covered in part 1. This section begins broadly by reviewing surgical eligibility criteria, benefits of GCS, and factors associated with regret for transgender men and women...
February 14, 2018: Sexual Medicine Reviews
K J Bernabé, N J Nokoff, D Galan, D Felsen, C E Aston, P Austin, L Baskin, Y-M Chan, E Y Cheng, D A Diamond, R Ellens, A Fried, S Greenfield, T Kolon, B Kropp, Y Lakshmanan, S Meyer, T Meyer, A M Delozier, L L Mullins, B Palmer, A Paradis, P Reddy, K J Scott Reyes, M Schulte, J M Swartz, E Yerkes, C Wolfe-Christensen, A B Wisniewski, D P Poppas
INTRODUCTION: Prior studies of outcomes following genitoplasty have reported high rates of surgical complications among children with atypical genitalia. Few studies have prospectively assessed outcomes after contemporary surgical approaches. OBJECTIVE: The current study reported the occurrence of early postoperative complications and of cosmetic outcomes (as rated by surgeons and parents) at 12 months following contemporary genitoplasty procedures in children born with atypical genitalia...
February 1, 2018: Journal of Pediatric Urology
Wouter B van der Sluis, Nicola Pavan, Giovanni Liguori, Stefano Bucci, Marta R Bizic, Vladimir Kojovic, Jochen Hess, Wilhelmus J H J Meijerink, Margriet G Mullender, Müjde Özer, Jan Maerten Smit, Marlon E Buncamper, Susanne Krege, Miroslav L Djordjevic, Carlo Trombetta, Mark-Bram Bouman
OBJECTIVES: To describe surgical outcomes of ileal vaginoplasty in transgender women and patients with disorders of sex development (DSD). PATIENTS AND METHODS: Transgender women and DSD patients, who underwent ileal vaginoplasty at the VU University Medical Center Amsterdam, University Hospital Trieste, University Hospital Essen and Belgrade University Hospital, were retrospectively identified. A chart review was performed, recording surgical technique, intraoperative characteristics, complications and reoperations...
February 1, 2018: BJU International
Roberto Cuomo, Luca Grimaldi, Cesare Brandi, Andrea Sisti, Giuseppe Nisi
No abstract text is available yet for this article.
January 15, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Zhi Wang, Jiuzuo Huang, Ang Zeng, Ming Wu, Xiaojun Wang
Various methods are available for vaginoplasty, but many of them have the drawbacks including surgical complexity and postoperative pain at the donor site. We herein evaluated the outcomes of vaginoplasty using tissue-engineered biomaterial graft. This study included 16 early stage cervical cancer patients who received curative surgery in combination with radiotherapy. They underwent vaginoplasty with tissue-engineered biological material, acellular dermal matrix (ADM). After treatment, a vaginal dilator was advised to be used for 6 months to prevent contraction of vagina...
January 5, 2018: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Leah Saylor, Shenell Bernard, Xochitl Vinaja, Marios Loukas, Justine Schober
Gender reaffirmation surgery is the final step in an individual's transition to their preferred gender. A clear understanding of the anatomy pertinent to this procedure is essential by the surgeon and patient. In male-to-female transgenders, female genitalia is constructed using the individual's penile skin to form the neovaginal canal and their scrotal skin folds post orchiectomy to create the labia majora. The surgical precursors of the remaining anatomical structures of the female genitalia are as follows: the clitoris is crafted from the glans penis and hence retains its innervation, the labia minora is formed using excess penile skin tissue, and the long male urethra is shortened to that of its feminine counterpart...
March 2018: Clinical Anatomy
Oscar J Manrique, M Diya Sabbagh, Pedro Ciudad, Jorys Martinez-Jorge, Kidakorn Kiranantawat, Ngamcherd Sitpahul, Todd B Nippoldt, Ali Charafeddine, Hung-Chi Chen
INTRODUCTION: Vaginal reconstruction and vaginoplasty are indicated in vaginal agenesis, following pelvic tumor resection, trauma and for gender confirmation surgery. Different surgical options have been described when using these techniques. Herein, we present the clinical outcomes and sexual function evaluation using the pedicle transverse colon flap (TCF) for gender confirmation surgery in transgender women. METHODS: This is a retrospective chart review of all transgender women who underwent gender confirmation surgery using the pedicle TCF...
November 11, 2017: Plastic and Reconstructive Surgery
Dmitry Zavlin, Jürgen Schaff, Jean-Daniel Lellé, Kevin T Jubbal, Peter Herschbach, Gerhard Henrich, Benjamin Ehrenberger, Laszlo Kovacs, Hans-Günther Machens, Nikolaos A Papadopulos
BACKGROUND: Currently available patient-reported outcome measures are limited in the field of sex reassignment surgery (SRS). Standardized questionnaires deliver high evidence data on satisfaction of male-to-female (MTF) transgender patients but do not allow any modification in their clinical application. We therefore designed a prospective study using self-developed indication-specific questionnaires to evaluate the aesthetic, functional, and sexual outcomes of MTF patients undergoing SRS...
November 3, 2017: Aesthetic Plastic Surgery
Gürkan Uncu, Kemal Özerkan, Barış Ata, Işıl Kasapoğlu, Mehmet Aral Atalay, Adnan Orhan, Kiper Aslan
OBJECTIVE: To describe modifications to the double-layer peritoneal pull-down laparoscopic vaginoplasty technique (Davydov operation) and evaluate anatomic and functional outcomes of the new technique, known as the Uncu modification. DESIGN: Case series (Canadian Task Force classification III). SETTING: Tertiary care university hospital. PATIENTS: Women with Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS) who underwent surgery between 2010 and 2016...
October 19, 2017: Journal of Minimally Invasive Gynecology
Yuko Mukai, Toshiyuki Watanabe, Morito Sugimoto, Yoshihiro Kimata, Yuzaburo Namba
Many vaginoplasty techniques have been introduced to improve the outcomes of sex reassignment surgery for male-to-female transsexuals. Some vaginoplasty patients still require additional skin grafts, making dilation mandatory to overcome shrinkage. We developed a new vaginoplasty method (called the "pudendal-groin flap") that uses pudendal-groin flaps. One of this procedure's advantages is that skin grafts are unnecessary, even for patients with small penises and scrotums. We introduce the procedure here and describe our evaluation of its utility...
October 2017: Acta Medica Okayama
Rodrigo Uliano Moser da Silva, Fernando Jahn da Silva Abreu, Gabriel M V da Silva, João Vitor Quadra Vieira Dos Santos, Nelson Sivonei da Silva Batezini, Brasil Silva, Tiago Elias Rosito
INTRODUCTION: After the diagnosis of transsexualism is confirmed therapy commences with psychotherapeutic preparation for the conversion, and after conversion, long-term patient rehabilitation is maintained for at least two years. The indication for surgery is chronic discomfort caused by discord with the patient's natural gender, intense dislike of developing secondary sex characteristics and the onset of puberty. The surgical conversion of transsexuals is the main step in the complex care of these problematic patients (1)...
October 17, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Thomas W Gaither, Mohannad A Awad, E Charles Osterberg, Gregory P Murphy, Angelita Romero, Marci L Bowers, Benjamin N Breyer
PURPOSE: Studies of surgical complications of penile inversion vaginoplasty are limited due to small sample sizes. We describe postoperative complications after penile inversion vaginoplasty and evaluated age, body mass index and years on hormone replacement therapy as risk factors for complications. MATERIALS AND METHODS: We retrospectively reviewed the records of male to female patients who presented for primary penile inversion vaginoplasty to a high volume surgeon (MLB) from 2011 to 2015...
October 12, 2017: Journal of Urology
Shu-Yi Wei, Feng-Yong Li, Qiang Li, Sen-Kai Li, Chuan-De Zhou, Yu Zhou, Yu-Jiao Cao, Si-Ya Zhang, Yang Zhao
BACKGROUND: The inverted peno-scrotal flap method is considered the standard method of vaginoplasty in male-to-female genital reassignment surgery. Though with numerous advantages, the method has its limitations regarding skin texture, lack of inherent lubrication, and that the tissues for creating the labia depend on the amount of tissues remaining after vaginoplasty. Our purpose was to describe the procedure and outcome of vaginoplasty applying a new technique: autologous buccal micro-mucosa free graft combined with posterior scrotal flap transfer, which could solve some of the problems the previous methods had...
February 2018: Aesthetic Plastic Surgery
Marta R Bizic, Borko Stojanovic, Miroslav L Djordjevic
INTRODUCTION: Gender dysphoria is defined as one's belief that his/her body does not reflect his/her true "inner" identification of physical sex and requires medical and/or surgical treatment that will alter his/her body to better reflect what he/she believes is his/her true gender. OBJECTIVE: The aim was to describe current surgical techniques available in genital reconstruction for female-to-male (FTM) and male-to-female (MTF) transgender patients. STUDY DESIGN: We reviewed recently published papers concerning the most common procedures in genital reconstruction in FTM transgenders and in MTF transgenders...
October 2017: Journal of Pediatric Urology
Zhihong Xie, Xiaoping Zhang, Ningzhi Zhang, Hong Xiao, Yongying Liu, Jiandong Liu, Lili Chen, Liang Li, Linlin Zhang, Youguo Zhang
OBJECTIVE: To explore the characteristics of congenital vaginal atresia, further improve its classification, and therefore help the clinical diagnosis and treatment of congenital vaginal atresia. METHODS: This was a retrospective study of 67 patients with congenital vaginal atresia (from March 1984 to March 2015). Clinical and surgical characteristics were analyzed. RESULTS: For lower vaginal atresia, 25 patients successfully underwent vaginoplasty at the lower portion of the vagina...
October 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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