Vaginectomy and laparoscopically assisted vaginal hysterectomy as adjunctive surgery for female-to-male transsexual reassignment: preliminary report

Ergeneli, M. H.; Duran, Eyup Hakan; Özcan, Gürhan; Erdoğan, Mehmet Ali

doi:10.1016/s0301-2115(99)00091-3

Cited by 29 publications

(13 citation statements)

References 4 publications

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“…This intervention could take up to 10 h of anaesthesia time, which resulted in an increased operative risk and substantial blood loss [4]. A few years later we changed our approach and we performed the subcutaneous mastectomy as a separate first step during the real-life test, because this operation greatly facilitates the adjustment to a male life style.…”

Section: Introductionmentioning

confidence: 99%

Two-stage versus one-stage sex reassignment surgery in female-to-male transsexual individuals

et al. 2006

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The objective was to compare the outcome of a combined total hysterectomy-vaginectomy-phalloplasty procedure vs. a vaginectomy-phalloplasty procedure in female-to-male (FTM) gender dysphoric individuals, and to report on a large series of vaginectomies in young women. This was a retrospective study and the setting was the Gender Team at Ghent University Hospital. One hundred and five consecutive cases of vaginectomyphalloplasty with (one-stage) or without (two-stage) total hysterectomy between 1993 and 2003 were included in the study. Patient files of 69 one-stage and of 36 two-stage procedures were reviewed and analysed. Operation time, the need for transfusions, complications, repeated surgery and hospitalisation time were the main outcome measures. Patients were equally distributed over the study period of 10 years. Comparing the two groups, there was a greater need for transfusion in the group of patients undergoing the one-stage procedure. There was no difference in operation time, rate of major complications or hospitalisation time. One-stage sex reassignment surgery (SRS) in FTM transsexual individuals is associated with more blood loss. However, there is no difference in operative and postoperative complications. Vaginectomy seems to be a safe and relatively simple procedure in FTM transsexual patients.

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Section: Introductionmentioning

confidence: 99%

Two-stage versus one-stage sex reassignment surgery in female-to-male transsexual individuals

et al. 2006

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“…Complications described are mostly urological: 3.5–14.3% persistent urinary retention [12, 13, 21], and one paper describes 12.5% bladder perforation (1/8 patients) [22]. Complication rates for fistula (vesicovaginal or rectovaginal) are not reported in the literature, although there is a reported 0.7% incidence on rectal lacerations during surgery that involved the posterior vaginal wall [23].…”

Section: Discussionmentioning

confidence: 99%

Robot-assisted laparoscopic colpectomy in female-to-male transgender patients; technique and outcomes of a prospective cohort study

et al. 2016

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BackgroundGender-affirming surgeries in female-to-male (FtM) transgender patients include mostly hysterectomy, bilateral salpingo-oophorectomy and mastectomy. Sometimes further surgery is performed, such as phalloplasty. Colpectomy may be performed to overcome gender dysphoria and disturbing vaginal discharge; furthermore, it may be important in reducing the risk of fistulas due to the phalloplasty procedure with urethral elongation. Colpectomy prior to the reconstruction of the neourethra seems to reduce fistula rates on the very first anastomosis. Therefore, at our center, colpectomy has become a standard procedure prior to phalloplasty and metoidioplasty with urethral elongation. Colpectomy is known as a procedure with potentially serious complications, e.g., extensive bloodloss, vesicovaginal fistula or rectovaginal fistula. Colpectomy performed via the vaginal route can be a challenging procedure due to lack of exposure of the surgical field, as many patients are virginal. Therefore, we investigated whether robot-assisted laparoscopic hysterectomy with bilateral salpingo-oophorectomy (TLH–BSO) followed by robot-assisted laparoscopic colpectomy (RaLC) is an alternative for the vaginal approach.MethodsRobot TLH/BSO and RaLC as a single-step procedure was performed in 36 FtM patients in a prospective cohort study.ResultsMedian length of the procedure was 230 min (197–278), which reduced in the second half of the patients, median blood loss was 75 mL (30–200), and median discharge was 3 days (2–3) postoperatively. One patient with a major complication (postoperative bleeding with readmission and transfusion) was reported.ConclusionTo our knowledge, this is the first report of RaLC. Our results show that RaLC combined with robot TLH–BSO is feasible as a single-step surgical procedure in FtM transgender surgery. Future studies are needed to compare this technique to the two-step surgical approach and on its outcome and complication rates of subsequent phalloplasty.Electronic supplementary materialThe online version of this article (doi:10.1007/s00464-016-5333-8) contains supplementary material, which is available to authorized users.

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“…The first is a preliminary report from Ergeneli et al, which describes the technique of laparoscopically assisted vaginal hysterectomy and vaginectomy in eight patients [16]. They encountered one bladder perforation.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic hysterectomy as the method of choice for hysterectomy in female-to-male gender dysphoric individuals

et al. 2008

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The objective of this paper was to report on a large series of laparoscopic hysterectomy in female-to-male (FTM) transsexual patients. A retrospective study was carried out by the gender team of Ghent University Hospital, Ghent, Belgium. The patient files of 83 consecutive cases of laparoscopic hysterectomy between April 2003 and August 2007 were reviewed and analyzed. The average operating time for the laparoscopic hysterectomy was 64 (30-150) min. The estimated blood loss for the laparoscopic hysterectomy averaged 86 (25-600) ml. We encountered two bladder perforations, which were immediately repaired, and one hematoma of the vaginal dome, which necessitated a second intervention. The serious complication rate of our series is 3.6%. Sex reassignment surgery (SRS) has proven to be the most effective treatment for patients with gender dysphoria. In FTM transsexual individuals, hysterectomy is an essential part of SRS. Since 2003, we have performed laparoscopic hysterectomy in conjunction with a subcutaneous mastectomy as a first step in SRS in FTM transsexual patients, thus, facilitating the transition for the patient and improving the operative planning for the different surgical teams. Laparoscopic hysterectomy has undoubtedly proven to be superior to abdominal hysterectomy regarding postoperative pain and recuperation, while it is as safe as the vaginal or abdominal route. We think that laparoscopic hysterectomy is the most appropriate method for hysterectomy in FTM transsexual patients.

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Vaginectomy and laparoscopically assisted vaginal hysterectomy as adjunctive surgery for female-to-male transsexual reassignment: preliminary report

Cited by 29 publications

References 4 publications

Two-stage versus one-stage sex reassignment surgery in female-to-male transsexual individuals

Two-stage versus one-stage sex reassignment surgery in female-to-male transsexual individuals

Robot-assisted laparoscopic colpectomy in female-to-male transgender patients; technique and outcomes of a prospective cohort study

Laparoscopic hysterectomy as the method of choice for hysterectomy in female-to-male gender dysphoric individuals

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