Transneovaginal repair of vesiconeovaginal fistula in female transgender

Toledo, Luís Gustavo Morato de; Moreira, Raphael de Jesus; Tosi, Lucas de Almeida

doi:10.1007/s00192-018-3670-y

Cited by 2 publications

(1 citation statement)

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“…After full review, 18 publications remained regarding rectal complications after PIV. 3,4,8–23 ( See Figure, Supplemental Digital Content 1 , which shows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram, http://links.lww.com/PRS/F982.) Average sample size was 121 patients, with a range of one to 475.…”

Section: Resultsmentioning

confidence: 99%

Rectal Injury during Penile Inversion Vaginoplasty: An Algorithmic Approach to Prevention and Management

Morris

Wang

Holan

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Background: Penile inversion vaginoplasty (PIV) is a common procedure for transfeminine patients, with the goal of creating a functional vaginal canal and clitoris and a natural-appearing vulva. Creation of the neovagina requires opening of the prerectal space, most commonly from a perineal approach, and the reported rates of rectal perforation during this dissection range from 3% to 5%. Methods: Adult patients who underwent PIV at the authors’ institution were identified retrospectively. Demographics, operative information, and postoperative clinical outcomes were extracted from the electronic medical record. Results: Ten of 146 patients (6.8%) experienced a rectal injury. All patients underwent an immediate repair (two-layer repair in eight patients, and three-layer repair in two), with two patients subsequently requiring temporary fecal diversion and two requiring muscle flaps (1.4% each). Literature review identified 18 relevant publications, with scarce in-depth analysis of management of initial rectal injuries. Conclusion: The authors’ algorithmic approach to rectal injury during PIV is designed to facilitate decision-making based on preoperative preparation, consistent intraoperative monitoring, feasibility of primary repair of the rectum, and a multidisciplinary approach to longitudinal postoperative care. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

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Section: Resultsmentioning

confidence: 99%