TY - JOUR
T1 - Ileal vaginoplasty as vaginal reconstruction in transgender women and patients with disorders of sex development: an international, multicentre, retrospective study on surgical characteristics and outcomes
T2 - an international, multicentre, retrospective study on surgical characteristics and outcomes
AU - van der Sluis, Wouter B.
AU - Pavan, Nicola
AU - Liguori, Giovanni
AU - Bucci, Stefano
AU - Bizic, Marta R.
AU - Kojovic, Vladimir
AU - Hess, Jochen
AU - Meijerink, Wilhelmus J. H. J.
AU - Mullender, Margriet G.
AU - Özer, M. jde
AU - Smit, Jan Maerten
AU - Buncamper, Marlon E.
AU - Krege, Susanne
AU - Djordjevic, Miroslav L.
AU - Trombetta, Carlo
AU - Bouman, Mark-Bram
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Objective: To describe the surgical outcomes of ileal vaginoplasty in transgender women and patients with disorders of sex development (DSD). Patients and Methods: Transgender women and patients with DSD, 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 re-operations. Results: We identified a total of 32 patients (27 transgender and five non-transgender), with a median (range) age of 35 (6–63) years. Ileal vaginoplasty was performed as the primary procedure in three and as a revision procedure in the remaining 29. The mean (sd) operative time was 288 (103) min. The procedure was performed laparoscopically (seven patients) or open (25). An ileal ‘U-pouch’ was created in five patients and a single lumen in 27. Intraoperative complications occurred in two patients (one iatrogenic bladder damage and one intraoperative blood loss necessitating transfusion). The median (range) hospitalisation was 12 (6–30) days. Successful neovaginal reconstruction was achieved in all. The mean (sd) achieved neovaginal depth was 13.2 (3.1) cm. The median (range) clinical follow-up was 35 (3–159) months. In one patient a recto-neovaginal fistula occurred, which lead to temporary ileostomy. Introital stenosis occurred in four patients (12.5%). Conclusion: Ileal vaginoplasty can be performed with few intra- and postoperative complications. It appears to have similar complication rates when compared to sigmoid vaginoplasty. It now seems to be used predominantly for revision procedures.
AB - Objective: To describe the surgical outcomes of ileal vaginoplasty in transgender women and patients with disorders of sex development (DSD). Patients and Methods: Transgender women and patients with DSD, 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 re-operations. Results: We identified a total of 32 patients (27 transgender and five non-transgender), with a median (range) age of 35 (6–63) years. Ileal vaginoplasty was performed as the primary procedure in three and as a revision procedure in the remaining 29. The mean (sd) operative time was 288 (103) min. The procedure was performed laparoscopically (seven patients) or open (25). An ileal ‘U-pouch’ was created in five patients and a single lumen in 27. Intraoperative complications occurred in two patients (one iatrogenic bladder damage and one intraoperative blood loss necessitating transfusion). The median (range) hospitalisation was 12 (6–30) days. Successful neovaginal reconstruction was achieved in all. The mean (sd) achieved neovaginal depth was 13.2 (3.1) cm. The median (range) clinical follow-up was 35 (3–159) months. In one patient a recto-neovaginal fistula occurred, which lead to temporary ileostomy. Introital stenosis occurred in four patients (12.5%). Conclusion: Ileal vaginoplasty can be performed with few intra- and postoperative complications. It appears to have similar complication rates when compared to sigmoid vaginoplasty. It now seems to be used predominantly for revision procedures.
KW - complications
KW - gender dysphoria
KW - reconstructive surgical procedures
KW - sex reassignment procedures
KW - transgender surgery
KW - vaginoplasty
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85043243380&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/29388351
UR - http://www.scopus.com/inward/record.url?scp=85043243380&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/bju.14155
DO - https://doi.org/10.1111/bju.14155
M3 - Article
C2 - 29388351
SN - 1464-4096
VL - 121
SP - 952
EP - 958
JO - BJU international
JF - BJU international
IS - 6
ER -