Symptomatic HPV-related neovaginal lesions in transgender women: case series and review of literature

Sluis, Wouter B. van der; Buncamper, Marlon E.; Bouman, Mark‐Bram; Neefjes-Borst, E. Andra; Heideman, Daniëlle A.M.; Steenbergen, Renske D.M.; Mullender, Margriet G.

doi:10.1136/sextrans-2015-052456

Cited by 25 publications

(24 citation statements)

References 8 publications

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“…Histological changes may occur because the grafted tissue is subject to new stressors, such as exposure to semen or micro-injuries during intercourse exposing the basal membrane, the primary binding site for HPV. The vulnerability of particular tissues to HPV infections and premalignant changes remains unclear, as only case studies of dysplasia and neovaginal cancers have been published [ 2 – 5 ]. It is suggested that squamous cell cancers occur in skin-graft neovaginas, whereas adenocarcinomas occur in intestinal neovaginas [ 2 , 4 ], but most reports have not investigated MRKH patients operated with Davidov’s method.…”

Section: Discussionmentioning

confidence: 99%

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A Mayer-Rokitansky-Kuster-Hauser patient with leiomyoma and dysplasia of neovagina: a case report

et al. 2020

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Background Most patients with congenital uterus and vaginal aplasia (i.e., Mayer–Rokitansky–Kuster–Hauser [MRKH] syndrome) have rudimentary pelvic uterine structures that contain smooth muscle. Although leiomyomas and dysplasia of vaginal mucosa are relatively common in the general population, they are rare in MRKH patients. Data on the vulnerability of neovaginas to HPV-associated dysplasia are limited. Case presentation A rare case of an MRKH patient with two gynaecological conditions detected during long-term gynaecological follow-up is presented. At the age of 21, the patient was treated for HPV-associated neovaginal dysplasia. At the age of 47, a pelvic leiomyoma was detected with transvaginal ultrasound and confirmed with magnetic resonance imaging. Conclusion A Pap smear or human papillomavirus testing is indicated in sexually active MRKH women. Uterine rudiments contain smooth muscle, which facilitates the development of oestrogen-dependent diseases, such as leiomyomas and adenomyosis. Although magnetic resonance imaging is recommended in cases of a pelvic mass, easily attainable and cost-efficient transvaginal ultrasound offers high diagnostic accuracy in patients with a surgically created neovagina and is suitable for the patients’ follow-up. Guidelines for the gynaecological follow-up of MRKH patients are warranted.

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Section: Discussionmentioning

confidence: 99%

“…Additionally, the literature on the prevalence of HPV positivity in neovaginas is limited [ 3 , 5 , 6 ], but the rate of occurrence seems similar to that in the general population [ 6 ]. The present case demonstrated that serial HPV infections may also occur in MRKH women.…”

Section: Discussionmentioning

confidence: 99%

A Mayer-Rokitansky-Kuster-Hauser patient with leiomyoma and dysplasia of neovagina: a case report

et al. 2020

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“…16 Like all keratinized skin, the neovagina is also susceptible to HPVinduced dysplasia. 45 When intestinal vaginoplasty is performed, the neovagina is lined with intestinal, often ileal, mucosal tissue. HPV-related penile cancer is less common than colorectal and anal cancers, making the risk of cancer theoretically higher in neovaginas lined with colonic mucosa compared with neovaginas lined with keratinized penile shaft skin.…”

Section: Cervical Cancermentioning

confidence: 99%

Care and Cancer Screening of the Transgender Population

Puechl

Russell

Gray

2019

Journal of Women's Health

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As sex and gender are assigned at birth before gender identity development, many individuals experience feelings of discordance between their gender identity and their sex and gender assigned at birth. The transgender community has not been well understood by medical and mental health fields. As such, this marginalized and vulnerable community faces multiple barriers to receiving health maintenance and specialized care, both at the community and patient-specific level. Many transgender individuals undergo some form of transition to the gender that matches their gender identity. Transition efforts look different for each patient because gender and gender identity occur along a continuum. Transition may include social, hormonal, and/or surgical components. As providers are caring for transgender patients, it is imperative to understand where a patient is in their gender transition and how hormonal and/or surgical therapies affect their cancer risk and screening. The aim of this article is to describe appropriate cancer screening practices and important care considerations for the primary care physician and generalist gynecologist taking care of transgender individuals.

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“…A few benign conditions have also been reported in the neovaginas of transgender women. Several studies have demonstrated the presence of condyloma accuminata in transgender women, mainly in neovaginas constructed from penile and scrotal tissues (Brown et al, 2015, Galea et al, 2015, Nureña et al, 2013, van der Sluis et al, 2016). These lesions can present with coital pain and bleeding (van der Sluis et al, 2016).…”

Section: Benign Neovaginal Diseasementioning

confidence: 99%

Medical dermatologic conditions in transgender women

Mundluru

Larson

2018

International Journal of Women's Dermatology

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Many previous reviews and studies on transgender dermatology have highlighted the expected dermatologic manifestations of hormone affirmation therapy in transgender patients. Others have highlighted attitudes and practices of both transgender patients and medical professionals taking care of these patients. This review compiles data from other, lesser known aspects of transgender dermatology, including neovaginal concerns, neoplastic concerns (both neovaginal and cutaneous), autoimmune conditions, and the sequelae of injectable substances that have not been approved by the U.S. Food and Drug Administration. This review, like others, will be a stepping-stone and serve as an impetus for future research in transgender dermatology.

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Symptomatic HPV-related neovaginal lesions in transgender women: case series and review of literature

Abstract: Neovaginal HPV infection can lead to benign condylomata (lrHPV) and various grades of dysplasia (hrHPV). We advise physicians to consider HPV infection and associated lesions in transgender women with otherwise unexplainable neovaginal pain or bleeding after vaginoplasty.

Cited by 25 publications

References 8 publications

A Mayer-Rokitansky-Kuster-Hauser patient with leiomyoma and dysplasia of neovagina: a case report

A Mayer-Rokitansky-Kuster-Hauser patient with leiomyoma and dysplasia of neovagina: a case report

Care and Cancer Screening of the Transgender Population

Medical dermatologic conditions in transgender women

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