Abstract
Introduction
Gender-affirmation surgery is often the final gender-confirming medical intervention sought by those patients suffering from gender dysphoria. In the male-to-female transgendered patient, the creation of aesthetic and functional external female genitalia with a functional vaginal channel is of the utmost importance. The aim of this review and meta-analysis is to evaluate the epidemiology, presentation, management and outcomes of neovaginal complications in the male-to-female transgender reassignment surgery patients.
Materials and Methods
PUBMED was searched a in accordance with PRISMA guidelines for relevant articles (n=125). Ineligible articles were excluded and articles meeting all inclusion criteria went on to review and analysis (n=13).
Results
Ultimately, studies reported on 1684 patients with an overall complication rate of 32.5% and a reoperation rate of 21.7% for non-aesthetic reasons. The most common complication was stenosis of the neo-meatus (14.4%). Wound infection was associated with an increased risk of all tissue-healing complications. Use of sacrospinous ligament fixation (SSL) was associated with a significantly decreased risk of prolapse of the neovagina.
Conclusions
Gender-affirmation surgery is important in the treatment of gender dysphoric patients, but there is a high complication rate in the reported literature. Variability in technique and complication reporting standards makes it difficult to assess the accurately the current state of male-to-female gender reassignment surgery. Further research and implementation of standards is necessary to improve patient outcomes. This article is protected by copyright. All rights reserved.
from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2gw0egU
