Stress urinary incontinence after male to female gender reassignment surgery: Successful use of a pubo-vaginal sling

Dangle, Pankaj P.; Harrison, Simon

doi:10.4103/0970-1591.33731

Cited by 9 publications

(2 citation statements)

References 4 publications

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“…Urge and stress incontinence were reportedly observed post MtF GRS, however, documentation, evaluation and intervention for these complaints was not well elucidated. Commonly reported functional urinary problems after vaginoplasty include stress, urinary incontinence or urgency symptoms (66%), obstruction (33%), and urinary tract infections (2%) (Lawrence, ; Dangle and Harrison, ; Goddard et al, ; Amend et al, ). In a study comparing FtM versus MtF, Hoebeke et al () found that while less urinary changes were present in the MTF group than the FtM, the major change for MtF was incontinence, present in 16% of patients with urge, stress, and mixed urinary incontinence.…”

Section: Discussionmentioning

confidence: 99%

Complications of the neovagina in male‐to‐female transgender surgery: A systematic review and meta‐analysis with discussion of management

et al. 2017

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Gender-affirmation surgery is often the final gender-confirming medical intervention sought by those patients suffering from gender dysphoria. In the male-to-female (MtF) transgendered patient, the creation of esthetic 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 MtF transgender reassignment surgery patients. PUBMED was searched 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). Ultimately, studies reported on 1,684 patients with an overall complication rate of 32.5% and a reoperation rate of 21.7% for non-esthetic 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. 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 MtF gender reassignment surgery. Further research and implementation of standards is necessary to improve patient outcomes. Clin. Anat. 31:191-199, 2018. © 2017 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

Complications of the neovagina in male‐to‐female transgender surgery: A systematic review and meta‐analysis with discussion of management

et al. 2017

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“…Levator spasm as a result of surgical reconstruction may lead to pain and voiding changes (43). Surgical remedies for post-GGAS stress incontinence, for example, are not well studied and limited to case reports (44,45).…”

Section: Incidence Of Urinary Symptoms After Ggasmentioning

confidence: 99%

Urinary symptoms after genital gender-affirming penile construction, urethral lengthening and vaginectomy

Fascelli¹,

Sajadi²,

Dugi³

et al. 2023

Transl Androl Urol

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Transgender and non-binary (TGNB) individuals are seeking penile reconstruction in greater numbers; many pursue urethral lengthening surgery with a goal of voiding while standing. Changes in urinary function and urologic complications-i.e., urethrocutaneous fistulae and urinary stricture-are common. Familiarity with presenting symptoms and management strategies for urinary complaints after genital gender-affirming surgery (GGAS) can improve patient counseling and outcomes. We will describe current gender-affirming penile construction options with urethral lengthening and review associated urinary complications that present as urinary incontinence. The incidence and impact of lower urinary tract symptoms after metoidioplasty and phalloplasty are poorly characterized due to limited post-operative follow-up. Post-phalloplasty, urethrocutaneous fistula is the most common urethral complication, ranging in incidence from 15-70%. Assessment of concomitant urethral stricture is necessary. No standard technique exists for management of these fistula or strictures. Metoidioplasty studies report lower rates of stricture and fistula, 2% and 9% respectively. Other common voiding complaints include dribbling, urethral diverticula and vaginal remnants. History and physical exam in the post-GGAS evaluation require understanding of prior surgeries and attempted reconstructive efforts; adjuncts to physical exam include uroflowmetry, retrograde urethrography, voiding cysto-urethrogram, cystoscopy, and MRI. Following gender-affirming penile construction, TGNB patients may experience a host of urinary symptoms and complications that impact quality of life. Due to anatomic differences, symptoms require tailored evaluation which can be done by urologists in an affirming environment.

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Assessment and management of the male to female transgender patient

Rashid

Thomas

Bellringer

2016

Male Sexual Dysfunction

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Stress urinary incontinence after male to female gender reassignment surgery: Successful use of a pubo-vaginal sling

Cited by 9 publications

References 4 publications

Complications of the neovagina in male‐to‐female transgender surgery: A systematic review and meta‐analysis with discussion of management

Complications of the neovagina in male‐to‐female transgender surgery: A systematic review and meta‐analysis with discussion of management

Urinary symptoms after genital gender-affirming penile construction, urethral lengthening and vaginectomy

Assessment and management of the male to female transgender patient

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