Vulvar condylomatosis after sex reassignment surgery in a male-to-female transsexual: Complete response to imiquimod cream

Abstract

BackgroundThe number of patients seeking sex reassignment surgery is increasing. Approximately 1:30,000 adult males and 1: 100,000 adult females seek this procedure. Neovaginal-related disorders after sex reassignment surgery are increasingly more common. Vulvar condylomatosis is the clinical manifestation of HPV 6- and 11 infection in biological women. The same HPV-subtypes are associated with anogenital warts and penile intraepithelial neoplasia in biological men. We aim to present a case of vulvar condylomatosis after sex reassignment surgery in a male-to-female transsexual and its complete response to 5% imiquimod cream.CaseWe describe a case of a 19-year-old female transexual who presented one year after male to female sex reassignment surgery by inverted penile skin vaginoplasty with condyloma accuminata of the vulva. The patient had a complete response to imiquimod 5% cream 12 weeks after initiation of treatment.ConclusionGynecologists should be prepared to treat neovaginal-related disorders in male-to-female transsexuals.

Condylomata acuminata of the neovagina in a transgender woman treated with trichloroacetic acid

“…Reported treatments ranged from patient-administered methods podophyllotoxin or imiquimod, to physicianoperated methods, including CO 2 laser ablation, electrovaporization, surgical excision, and total colpectomy. [11][12][13][14][15][16][17][18] To our knowledge, this is the first case report of neovaginal warts successfully treated with TCA.…”

Sexual health after vaginoplasty: A systematic review

“…98 studies reported outcomes on sexual activity and behaviour 11,18,19,29‐31,33‐38,41‐45,47,48,50‐53,58,63‐65,67‐74,76‐80,87,91‐94,98‐150 . Of the standardized questionnaires, the Sheffield Prolapse Questionnaire and BISF‐W included questions about frequency of sexual activity 34,106,151 .…”

“…112 Verruca vulgaris-producing HPV strands presented in two cases, in which both patients had greater than one cis man sexual partner and was treated with imiquimod cream. 120,126 Matsuki et al (2015) also treated the lesions with a CO 2 laser. 126 High-risk HPV (hrHPV) strains were randomly sampled in 54 patients, and 6 women (all sexually active) tested positive for various hrHPV strains.…”

“…18,51,77,104,119,122 3.6.3 | Additional sexual health factors related to activity: STIs after vaginoplasty, severe complications due to intercourse and sexual violence STIs and vaginal candidiasis were outcome measurements that coincided with reports on sexual activity 109,112,120,126,131,146. Case reports and series reported findings of Candida, HSV-1, HPV, and C. trachomatis.…”

Evaluation of the Sexual and Urinary Functions of Transsexual Women

“…There is a consensus among health professionals that transsexual surgery and hormonal procedures have a positive impact on this dysphoria, although some people do not intend to undergo the surgical procedure to express their gender and identity role 3 . The number of people seeking SR surgery is gradually increasing 4 . There is a worldwide estimation that 1:30,000 adult trans women and 1:10,000 adult trans men seek the procedures annually.…”