Journal article
Male-to-Female Gender Reassignment Surgery: An Institutional Analysis of Outcomes, Short-term Complications, and Risk Factors for 240 Patients Undergoing Penile-Inversion Vaginoplasty
Urology (Ridgewood, N.J.), v 131, pp 228-233
Sep 2019
PMID: 31207304
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To report outcomes, complications, and risk factors of a population cohort undergoing male-to-female gender affirmation surgery via penile-inversion vaginoplasty by a single surgeon at a large academic institution. As gender dysphoria awareness increases among the medical community, so does the population of patients seeking gender-affirmation surgery.
A prospectively maintained database of patients undergoing penile-inversion vaginoplasty was retrospectively queried for all available patients with at least 1 week of postoperative follow-up. Univariate and multivariate analyses were performed using Fisher's exact test and logistic regression, respectively, in order to evaluate relationship of risk factors to complications at 30, 60, and 90 days, as well as the likelihood of revision/reoperation.
From November 2016 to April 2018, 240 penile-inversion vaginoplasties were performed. Median follow-up was 87 days. When accounting for competing risk factors, only noncompliance with postoperative dilation regimen and activity restriction was significantly associated with increased risk of complications or reoperation/revision. Overall incidence of reoperation/revision was 7.9% (n = 19). Reasons for reoperation included cosmesis (3.8%; n = 9), neovaginal stenosis (2.1%; n = 5), and wound dehiscence (0.8%; n = 2), with less than 0.5% (n = 1) reoperations for meatal stenosis, hematoma or rectovaginal fistula, respectively. Incidence of Clavien IIIa-b complications was 1.7% (n = 4). There were no Clavien IV-V complications.
At short-term follow-up, gender-affirmation surgery is associated with low rates of reoperation and revision and few major complications when performed by an experienced, high-volume surgeon. Patient selection and compliance is imperative. Increased reporting among surgeons is necessary to continue to improve patient outcomes.
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Details
- Title
- Male-to-Female Gender Reassignment Surgery: An Institutional Analysis of Outcomes, Short-term Complications, and Risk Factors for 240 Patients Undergoing Penile-Inversion Vaginoplasty
- Creators
- Jason A Levy - Hahnemann University Hospital, Department of Urology, Philadelphia, PA. Electronic address: jasonlevy89@gmail.comDaniel C Edwards - Hahnemann University HospitalPaulette Cutruzzula-Dreher - Hahnemann University HospitalBrian H McGreen - Hahnemann University HospitalShawon Akanda - Philadelphia College of Osteopathic MedicineSusan Tarry - Hahnemann University HospitalLaurence H Belkoff - Hahnemann University HospitalKathy L Rumer - Hahnemann University Hospital
- Publication Details
- Urology (Ridgewood, N.J.), v 131, pp 228-233
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000482627900060
- Scopus ID
- 2-s2.0-85068975047
- Other Identifier
- 991019168023904721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Urology & Nephrology