Life-Threatening Bleeding Following Penile Inversion Vaginoplasty: Case Analysis and Practice Improvement.

Eplasty Pub Date : 2023-12-01 eCollection Date: 2023-01-01

Rishub K Das, Patrick E Assi, Salam Al Kassis

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Abstract

Background: Gender-affirming surgery is a medically necessary treatment for transgender and gender diverse patients experiencing gender dysphoria. Preliminary data demonstrate an association between gender-affirming surgery and improved mental health outcomes. Penile inversion vaginoplasty is the most frequently performed feminizing bottom surgery in transwomen. Importantly, complications associated with penile inversion vaginoplasty are not uncommon and can be life-threatening. Surgeons and other members of the health care team must be aware of these potential harms. However, there is a paucity of high-quality evidence reported in the literature about the management and breadth of complications regarding feminizing bottom surgery.

Case: A healthy 37-year-old woman who was assigned male at birth underwent gender-affirming orchiectomy, penile inversion vaginoplasty, and vulvar reconstruction. During routine vaginal packing removal in the postoperative period, there was an acute arterial bleed in the neovaginal canal, and hemostasis was achieved in the operating room.

Conclusions: We review the associated periprostatic anatomy and describe several practice improvements to mitigate postoperative complications.

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阴茎内翻阴道成形术后危及生命的出血：病例分析与实践改进。

背景：性别确认手术是变性人和性别多元化患者在医学上必须接受的一种治疗方法。初步数据显示，性别确认手术与改善心理健康结果之间存在关联。阴茎内翻阴道成形术是变性女性最常接受的女性化下体手术。重要的是，阴茎内翻阴道成形术的相关并发症并不少见，而且可能危及生命。外科医生和医疗团队的其他成员必须意识到这些潜在的危害。然而，关于女性化阴道底部手术并发症的处理和广泛性，文献中报道的高质量证据并不多：一位 37 岁的健康女性在出生时被指定为男性，她接受了确认性别的睾丸切除术、阴茎内翻阴道成形术和外阴重建术。在术后常规清除阴道填料的过程中，新阴道口出现急性动脉出血，在手术室完成止血：我们回顾了相关的阴道周围解剖，并介绍了几种可减少术后并发症的改进方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Eplasty

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