Postoperative complications of male to female sex reassignment surgery: A 10-year French retrospective study

Cristofari, S.; Bertrand, B.; Leuzzi, Sara; Rem, K.; Rausky, J.; Revol, M.; Atlan, Michaël; Stivala, Alessio

doi:10.1016/j.anplas.2018.08.002

Cited by 44 publications

(82 citation statements)

References 20 publications

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“…Consistent with the available literature, comorbid conditions and obesity does not appear to correlate with complication rate. 11 , 14 – 16 , 19 , 20 Although formal statistical analysis was not able to be carried out in a cohort this size, body mass index, smoking status, HIV status, and comorbid disease did not show a clear risk for complication.…”

Section: Discussionmentioning

confidence: 96%

“…The rate of rectal perforation in this study is 6.67%, which is higher than that presented elsewhere (between 2% and 5%). 7 – 11 , 19 – 22 However, there were only 2 instances of rectal perforation, which were within the first 10 patients operated on. There have been no further perforations since, and with accrual of further data, the rate of rectovaginal perforation will likely decline to be consistent with the literature.…”

Section: Discussionmentioning

confidence: 99%

“…Consideration must also be given to complications, most significantly, rectovaginal fistula, urinary retention or urethral stenosis, wound dehiscence, or neovaginal prolapse. 19 – 22 …”

Section: Introductionmentioning

confidence: 99%

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Transfeminine Gender Confirmation Surgery with Penile Inversion Vaginoplasty: An Initial Experience

Loree

Burke

Rippe

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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Background: To detail the early experience with and results of a transfeminine (TF) genital reconstruction at an established plastic surgery practice in Western New York. Methods: Between June 2016 and June 2019, 30 patients underwent penile inversion vaginoplasty for TF gender reassignment. All patients fulfilled World Professional Association for Transgender Health and NY State criteria for reassignment surgery. All surgeries were carried out at a large, government-owned tertiary care center. Results: There were 30 patients in this retrospective study, with a mean age of 37 years (SD 5.4) and a mean body mass index of 27.3 kg/m 2 (SD 3.2 kg/m 2 ). Nineteen patients never smoked, 4 were former smokers, and 7 were current smokers. Primary surgery was an orchiectomy and modified single-stage penile inversion vaginoplasty. Mean operative time was 6.0 hours. Mean initial hospital stay was 8.2 days. Three of the 30 (10%) patients required transfusion. There were 6 (20%) complications. Three complications (10%) required reoperation: 1 patient for wound dehiscence on postoperative day 7, 1 for rectal perforation identified on postoperative day 10, and 1 for urethrovaginal fistula. All complications were addressed without sequalae. Twenty of the 30 (66%) patients have undergone revision surgery. Indications for revision were prolapse correction/deepening, labiaplasty, clitoral hood construction/revision, meatal asymmetry, urinary fistula repair, and posterior vaginal flap revision. Twenty-one of 28 (75%) revisions were outpatient surgeries. There were no complications from these procedures. Overall satisfaction via survey was 92% (24 respondents). Conclusions: TF gender reassignment is a novel, challenging set of procedures for the specialty of plastic surgery. With appropriate consideration and technique, penile inversion vaginoplasty is a safe, effective means of achieving this goal.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

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Transfeminine Gender Confirmation Surgery with Penile Inversion Vaginoplasty: An Initial Experience

Loree

Burke

Rippe

et al. 2020

Plastic and Reconstructive Surgery - Global Open

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“…In our study, the haemostatic efficacy was moderate following sexual reassignment and a tonsillectomy. Sexual reassignment is a perilous surgery in which haemostasis during dissection of the corpus spongiosum is very difficult to manage and there is little objective and published data on this type of surgery, which may require transfusions in 15% of the cases 13 . The other case involved a tonsillectomy in a patient who bled when the scabs fell off.…”

Section: Discussionmentioning

confidence: 99%

“…The demographic characteristics of the patients are detailed in Table 1. For the 63 surgeries, the median rVWF dosages used were 63 (12-340) IU/kg and the median number of exposure days (ED) was 2 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14).…”

Section: Patientsmentioning

confidence: 99%

Efficacy and safety of a recombinant Von Willebrand Factor treatment in patients with inherited Von Willebrand Disease requiring surgical procedures

et al. 2021

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Introduction: Von Willebrand Disease is a common inherited haemorrhagic disorder due to a deficiency of Von Willebrand Factor (VWF). In case of surgical procedures in patients who are not responsive or have contraindications to desmopressin, replacement therapy with VWF concentrates is indicated. Until recently, only plasma-derived VWF concentrates were available. A new recombinant VWF (rVWF) concentrate that contains no Factor VIII (FVIII) but a high amount of high molecular weight VWF multimers has been available in France since 2018. Aim: Describe real-world experience of using rVWF in surgical procedures. Methods: Sixty-three surgeries for 55 patients were retrospectively analysed in 7 French haemostasis centres. Results: During minor surgeries, the median (range) number of infusions was 1 (1-8) with a preoperative loading dose of 35 (19-56) rVWF IU/kg and a total median dose of 37.5 IU (12-288). During major surgeries, the median (range) number of infusions was only 3 (1-14) with a median preoperative loading dose of 36 IU (12-51) rVWF IU/kg, and a total median dose of 108 IU (22-340) rVWF IU/kg. The overall clinical efficacy was qualified as excellent/good in 61 of the procedures (97%), moderate in 1 (1.5%) and poor in 1 (1.5%). There was no accumulation of VWF or FVIII during postoperative monitoring. No thromboembolic events, anti-VWF antibodies or adverse events were reported. Conclusion: This French 'real-world' experience shows that a few infusions and low doses of rVWF provided effective prevention of bleeding in major and minor surgeries in inherited VWD, with no clinically significant safety concerns. K E Y W O R D S inherited von Willebrand disease, recombinant VWF, surgical procedure | 271 DESPREZ Et al. How to cite this article: Desprez D, Drillaud N, Flaujac C, et al. Efficacy and safety of a recombinant Von Willebrand Factor treatment in patients with inherited Von Willebrand Disease requiring surgical procedures. Haemophilia.

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Strategies to Optimize Sexual Function with Feminizing and Masculinizing Genital Gender-Affirming Surgery

Garcia

2020

Gender Confirmation Surgery

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Postoperative complications of male to female sex reassignment surgery: A 10-year French retrospective study

Cited by 44 publications

References 20 publications

Transfeminine Gender Confirmation Surgery with Penile Inversion Vaginoplasty: An Initial Experience

Transfeminine Gender Confirmation Surgery with Penile Inversion Vaginoplasty: An Initial Experience

Efficacy and safety of a recombinant Von Willebrand Factor treatment in patients with inherited Von Willebrand Disease requiring surgical procedures

Strategies to Optimize Sexual Function with Feminizing and Masculinizing Genital Gender-Affirming Surgery

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