Sex reassignment of transsexual people from a gynecologist's and urologist's perspective

Trum, Hans; Hoebeke, Piet; Gooren, Louis

doi:10.1111/aogs.12618

Cited by 60 publications

(33 citation statements)

References 25 publications

(30 reference statements)

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“…The proposed classification in the present series could be of help for future histopathological investigations of urethral stricture disease. The control specimens with normal urethra came from patients who had undergone sex-correction surgery, and their preoperative treatment with oestradiol may have had an effect on the urethra; however, to the authors' knowledge, no evidence for this exists [23,24]. There are several strengths to the present study, including its prospective design, the consistent follow-up and the fact that the pathologist was blinded to the clinical outcome.…”

Section: Discussionmentioning

confidence: 98%

Sclerosis as a predictive factor for failure after bulbar urethroplasty: a prospective single-centre study

Ekerhult

Lindqvist

Grenabo

et al. 2018

Scandinavian Journal of Urology

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Objective: The aim of this study was to assess whether sclerosis in histology following bulbar urethroplasty is a predictive factor for failure of surgery. Materials and methods: Resected stricture specimens from 45 patients undergoing open urethroplasty with excision and anastomosis were collected prospectively during 2011-2014. Histopathological characteristics, including fibrosis (grade I-III), inflammation and sclerosis, were evaluated using different routine staining. These specimens were compared to normal urethral resection specimens from patients undergoing sex-correction surgery. The uropathologist who conducted the analyses was blinded to the study design. Results: The outcomes of the histological classifications were as follows: 19 patients had grade I fibrosis, of whom three had failures; 13 patients had grade II fibrosis, without any failures; and the most severe fibrosis, grade III, including sclerosis, was found in 13 patients (11 with sclerosis), with failure in eight. Sclerosis was a significant risk factor for restricture when comparing patients with sclerosis and those without sclerosis, and likewise when adjusting for age, inflammation and stricture length. Conclusion: Histological findings of sclerosis in the resected urethral stricture specimen indicate a significantly higher risk for restricture after urethroplasty surgery.

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Section: Discussionmentioning

confidence: 98%

Sclerosis as a predictive factor for failure after bulbar urethroplasty: a prospective single-centre study

Ekerhult

Lindqvist

Grenabo

et al. 2018

Scandinavian Journal of Urology

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“…Urinary complications (e.g., fistula, stenosis) following urethra reconstruction are high [3, 4, 6, 23]. …”

Section: Discussionmentioning

confidence: 99%

En Bloc Surgical Dissection for Penile Transplantation for Trans-Men: A Cadaveric Study

Selvaggi

Wesslen

Elander

et al. 2018

BioMed Research International

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Introduction The surgical techniques currently available for penile reconstruction for trans-men with gender dysphoria present with multiple drawbacks and often fail to meet patients' expectations. Literature reports three cases where penile transplantation has been performed for cis-men, with the last two cases being considered successful. Aim To determine whether an en bloc surgical dissection can be performed in a male cadaver, in order to include structures necessary for penile transplantation (from a deceased donor male) to a recipient with female genitalia in gender affirmation surgery. Method The study was conducted in the form of explorative dissections of the genital and pelvic regions of three male cadavers preserved in phenol-ethanol solution. Results The first two dissections failed to explant adequately all the relevant structures. The third dissection, which was performed along the pubic arch and through the perineum, succeeded in explanting the relevant structures: it, in fact, allowed for identification and adequate transection of urethra, vessels, dorsal nerves, crura of corpora cavernosa, and bulb of corpus spongiosum, in en bloc explantation of male genitalia. Conclusions It is possible to explant the penis and associated vessels, nerves, and urethra en bloc from a cadaver. This study suggests a surgical technique for en bloc explantation aiming for transplantation of the penis from a cadaveric donor male to a recipient with female genitalia.

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“…Although none of these studies have been conducted in the transgender population. Both the WPATH and the Endocrine society recommend transfeminine patients follow the current prostate cancer screening guidelines for cis-men with the caveat that 1 ng/ mL should be considered the upper threshold of normal (56,65,66). This guideline should be followed at any point in a patient's transition.…”

Section: Prostate Cancermentioning

confidence: 99%

Cancer screening in the transgender population: a review of current guidelines, best practices, and a proposed care model

Sterling

Garcia

2020

Transl Androl Urol

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Over the last 50 years cancer mortality has decreased, the biggest contributor to this decrease has been the widespread adoption of cancer screening protocols. These guidelines are based on large population studies, which often do not capture the non-gender conforming portion of the population. The aim of this review is to cover current guidelines and practice patterns of cancer screening in transgender patients, and, where evidence-based data is lacking, to draw from cis-gender screening guidelines to suggest best-practice screening approaches for transgender patients. We performed a systematic search of PubMed, Google Scholar and Medline, using all iterations of the follow search terms: transgender, gender non-conforming, gender non-binary, cancer screening, breast cancer, ovarian cancer, uterine cancer, cervical cancer, prostate cancer, colorectal cancer, anal cancer, and all acceptable abbreviations. Given the limited amount of existing literature inclusion was broad. After eliminating duplicates and abstract, all queries yielded 85 unique publications. There are currently very few transgender specific cancer screening recommendations. All the guidelines discussed in this manuscript were designed for cis-gender patients and applied to the transgender community based on small case series. Currently, there is not sufficient to evidence to determine the longterm effects of gender-affirming hormone therapy on an individual's cancer risk. Established guidelines for cisgender individuals and can reasonably followed for transgender patients based on what organs remain in situ. In the future comprehensive cancer screening and prevention initiatives centered on relevant anatomy and high-risk behaviors specific for transgender men and women are needed.

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Sex reassignment of transsexual people from a gynecologist's and urologist's perspective

Cited by 60 publications

References 25 publications

Sclerosis as a predictive factor for failure after bulbar urethroplasty: a prospective single-centre study

Sclerosis as a predictive factor for failure after bulbar urethroplasty: a prospective single-centre study

En Bloc Surgical Dissection for Penile Transplantation for Trans-Men: A Cadaveric Study

Cancer screening in the transgender population: a review of current guidelines, best practices, and a proposed care model

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