Objective
To describe the initial outcomes of a new multidisciplinary gender-affirming surgery
(GAS) program comprised of plastic and urologic surgeons.
Methods
We retrospectively examined consecutive patients who underwent gender-affirming vaginoplasty
or vulvoplasty between April 2018 and May 2021. We used logistic regression modeling
to analyze associations between pre-operative risk factors and post-operative complications.
Results
Between April 2018 and May 2021, 77 genital GAS (gender-affirming surgery) procedures
were performed at our institution (56 vaginoplasties, 21 vulvoplasties). All surgeries
were performed in combination with urology and plastic surgery primarily using the
perineal penile inversion technique. Mean patient age was 39.6 years, and mean BMI
was 26.2 (Table 1a). The most common pre-existing conditions were hypertension and
depression, with nearly 14% of patients reporting a previous suicide attempt.
The complication rate for vaginoplasty was 53.7% within the first 30 days (Table 4).
The most common complications were yeast infection (14.8%) and hematoma (9.3%). For
vulvoplasty, the 30-day complication rate was 57.1%, with urinary tract infection
(14.3%) and granulation tissue (9.5%) being the most common. 88.1% and 91.7% of the
complications were Clavien-Dindo grade I or II for vaginoplasties and vulvoplasties,
respectively. No association was found between pre-operative patient factors and post-operative
complications. Revision surgeries were performed for 38.9% of vaginoplasty patients
during the study period, most commonly including urethral revision (29.6%), labia
majoraplasty (20.4%), and labia minoraplasty (14.8%).
Conclusions
Collaboration between urology and plastic surgery is a safe and effective means to
establish a GAS program.
Keywords
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Article info
Publication history
Accepted:
March 1,
2023
Received:
December 21,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Conflict of Interest declaration: The authors declare that they have no affiliations with or involvement in any organization or entity with any financial interest in the subject matter or materials discussed in this manuscript.
Identification
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