Autologous Buccal Micro-Mucosa Free Graft combined with Posterior Scrotal Flap Transfer for Vaginoplasty in Male-To-Female Transsexuals: A Pilot Study

Wei, Shuyi; Li, Feng-Yong; Lu, Qiang; Li, Senkai; Zhou, Chunxia; Zhou, Yu; Cao, Yujiao; Zhang, Si-Ya; Zhao, Yang

doi:10.1007/s00266-017-0977-x

Cited by 13 publications

(23 citation statements)

References 22 publications

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“…46 studies measured or reported on erogenous sensation of post‐surgical genitalia including the vulva, clitoris, anus, or mons pubis 11,13,18,19,30,33,35,44,45,48,51,66,67,70‐103 . General erogenous sensation ranged from 51.4% to 100% (median 97.7%) in 529 patients 11,13,30,74,80,88,89,91,100,101 . Only De Andrade (2013) reported a qualified scale for genital sensibility, receiving a 9.4/10 among 7 patients 75 .…”

Section: Resultsmentioning

confidence: 99%

“…69 studies identified outcomes relating to sexual satisfaction/happiness of sex life and sexual function 11,16,29,31‐33,35‐39,41,44‐56,64,65,67,68,72,73,75‐79,85,86,94,95,98,99,101,102,106,107,114‐116,121,122,124,125,129,130,134,137,139,144,150,153‐160 . Satisfaction is included in FSFI, SPQ, BISF‐W, WHOQOL‐100, and Q‐SF.…”

Section: Resultsmentioning

confidence: 99%

“…42,58,[68][69][70]85,97,99,103,104,115,121,127,139,140,168 3.12 | Therapeutic aids 4 studies reported information regarding therapeutic aids for sexual engagement. 50,101,108,127 COVID-19 induces respiratory-predominant multiorgan dysfunction, including myocardial, renal, enteric and hepatic dysfunction, which coincides with the tissue expression of ACE2. 3 Meanwhile, several studies have shown that ACE2 is expressed in human testes (eg spermatogonia, Leydig cells and Sertoli cells), 4,5 suggesting that the testes may be another organ affected by COVID-19.…”

Section: Interferences/disruptions To Sexual Activitymentioning

confidence: 99%

“…3.8 | Satisfaction and function69 studies identified outcomes relating to sexual satisfaction/happiness of sex life and sexual function 11,16,29,[31][32][33][35][36][37][38][39]41,[44][45][46][47][48][49][50][51][52][53][54][55][56]64,65,67,68,72,73,[75][76][77][78][79]85,86,94,95,98,99,101,102,106,107,[114][115][116]121,122,124,<...>…”

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confidence: 99%

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Sexual health after vaginoplasty: A systematic review

et al. 2021

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Background: Vaginoplasty is a gender-affirming procedure for transgender and gender diverse (TGD) patients who experience gender incongruence. This procedure reduces mental health concerns and enhances patients' quality of life. A systematic review investigating the sexual health outcomes of vaginoplasty has not been performed. Objectives:To investigate sexual health after gender-affirming vaginoplasty for TGD patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Interferences/disruptions To Sexual Activitymentioning

confidence: 99%

mentioning

confidence: 99%

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Sexual health after vaginoplasty: A systematic review

et al. 2021

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“…Other less-invasive methods have been proposed, including Creatsas vaginoplasty (modified Williams method) [22], the labial and vestibular flap method [23], and the use of a small graft of perineal skin at the introitus to line the distal posterior aspect of the newly created vagina [24, 25]. In gender reassignment surgery, the most commonly used method is penile inversion vaginoplasty with scrotal flaps [26], sometimes combined with autologous buccal micro-mucosa free grafts [27]. However, several techniques have been attempted to cover (and epithelize) the newly formed vagina.…”

Section: Discussionmentioning

confidence: 99%

Clinical pilot study to evaluate the neovaginal PACIENA prosthesis® for vaginoplasty without skin grafts in women with vaginal agenesis

et al. 2019

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BackgroundTo evaluate the feasibility and clinical outcomes of vaginoplasties using a neovaginal polylactic acid prosthesis made with 3-dimensional (3D) printing technology as an intraneovaginal mould.MethodsThis was an interventionist, prospective, and multicentre clinical pilot investigation of a sanitary product (PACIENA prosthesis®) aiming to recruit and operate on 8 patients over 6 months with a follow-up period of 6 months. Only six patients with Rokitansky syndrome and one patient with Morris syndrome (7 patients in total) were operated on in two university hospitals: “La Fe”, Valencia (H1) and “Arrixaca”, Murcia (H2). Interventions: Extensive surgical dissection of a defined space between the urethra and bladder in the front and of the rectum in the back as well as insertion of the PACIENA prosthesis® covered with Interceed® were performed. After 12 days, the prosthesis was changed to the silicone-covered version for daily application.ResultsIn the 6 patients with Rokitansky syndrome (86%), the primary endpoint (satisfactory vaginal outcome in terms of appearance, function, and sensation without relevant additional morbidity) was achieved, although only 2 patients (28%) were sexually active at the end of 6 months of follow-up. The patient with Morris syndrome withdrew from the study after 1 month. Patients without bacterial colonization showed positive Schiller tests at 1 month, and subsequent biopsies showed adequate keratinization and epidermization. Epithelization and iodopositivity were delayed in the patients who developed inflammatory granulomas.ConclusionsGood anatomical and functional results can be achieved with the PACIENA prosthesis® for vaginoplasties without skin grafts. However, adequate patient selection and education, good surgical techniques and haemostasis, postoperative support, and prevention of bacterial colonization are important.Trial registrationThis clinical study was approved by the Ethical Clinical Investigation Committee of San Juan University Hospital on September 27, 2016, to be conducted in the participating centres; it was authorized by the Spanish Agency of Medicines and Health Products (AEMPS) on April 24, 2017 (exp. no. 585/16/EC), to be carried out in that hospitals.

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Gender‐affirming vaginoplasty: Technical considerations in patients with genital skin deficiency

Huang

Lai

Morgantini

et al. 2022

Neurourology and Urodynamics

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Introduction: Gender dysphoria affects over 1 million American adults. Vaginoplasty is a critical step in gender affirmation, and many patients have insufficient genital skin for full-depth penile inversion vaginoplasty (PIV). We reviewed the literature for technical considerations addressing this and present our data supporting the use of peritoneal flaps (Davydov technique). Materials and Methods:A comprehensive review of modern literature was conducted. Second, we present a retrospective case review of our experience with PIV, including data from procedures utilizing peritoneal flaps. Results: We identified 20 original articles, including retrospective and prospective case and cohort studies. Approaches included the application of local soft tissue grafts and flaps, peritoneal flaps, and intestinal segments. Between June 2018 and February 2021, 47 patients at our institution, underwent PIV for the treatment of gender dysphoria. Nineteen of those patients underwent robotic-assisted peritoneal flap procedure in addition to PIV. In this cohort, the mean follow-up was 200.6 ± 124.8 days. Mean neovaginal depth was 13.1 ± 3.0 cm intra-operatively and 11.0 cm at the last follow-up. Twenty-six percent of complications were Clavien Grade 1 or 2; others included wound dehiscence (30.4%), perianal and urethral fistula (13.0%), and neovaginal stenosis (8.7%). The majority of patients reported satisfactory results in terms of sexual function with intact tactile and erogenous sensation. Almost half were able to have penetrative vaginal intercourse at the last follow-up. We did not aim to perform statistical calculations to compare the outcomes of PIV with and without robotic-assisted peritoneal flap augmentation, as the groups were not constructed in that manner. However, it is evident that anatomical and functional results as well as the distribution of postoperative complications seem similar. Conclusion:Vaginoplasty is indicated in a growing population of patients with a wide range of medical histories and anatomic variations. Genitourinary reconstructive surgeons must have several methods to achieve full-depth Neurourol Urodyn.

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Autologous Buccal Micro-Mucosa Free Graft combined with Posterior Scrotal Flap Transfer for Vaginoplasty in Male-To-Female Transsexuals: A Pilot Study

Abstract: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Cited by 13 publications

References 22 publications

Sexual health after vaginoplasty: A systematic review

Sexual health after vaginoplasty: A systematic review

Clinical pilot study to evaluate the neovaginal PACIENA prosthesis® for vaginoplasty without skin grafts in women with vaginal agenesis

Gender‐affirming vaginoplasty: Technical considerations in patients with genital skin deficiency

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