Analysis of surgical complications and risk factors in genital feminization surgery: a retrospective cohort study of 407 transgender women.

IF 2.6 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Sexual Medicine Pub Date : 2025-07-10 eCollection Date: 2025-06-01 DOI:10.1093/sexmed/qfaf045

Fériel Ferchichi, Nicolas Morel-Journel, Damien Carnicelli, Lucas Freton, Lucie Jurek, Alain Ruffion, François-Xavier Madec, Paul Neuville

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引用次数: 0

Abstract

Background: Penile inversion vulvo-vaginoplasty with addition of a scrotal skin graft is a widely used technique in genital feminizing surgery for trans women.

Aim: To identify the types and frequencies of complications following genital feminizing surgery and assess associated risk factors.

Methods: A retrospective review was conducted on all trans women who underwent primary genital feminizing surgery at Lyon Sud University Hospital between 2008 and 2022. Inclusion criteria were age over 18 and a minimum follow-up of 1 year. Data were collected from electronic medical records and included demographic and clinical characteristics, surgical details, intraoperative events, postoperative complications, and revision procedures.

Outcomes: The study focused on the incidence of intraoperative, early, and late postoperative complications, as well as the frequency and types of surgical revisions.

Results: Among 407 patients (mean (SD) age of 38.6 (12.7) years, mean (SD) BMI of 24.7), intra-operative rectal injury occurred in 5 patients (1.2%). Early graft failure requiring revision was seen in 1%, and 23.1% underwent secondary revisions. Late complications included recto-neovaginal fistula (0.5%) and vaginal stenosis requiring revision (3.4%). Labiaplasty was the most frequent revision procedure (n = 68). Younger age was associated with increased early revisions, while BMI and smoking were not.

Clinical implications: Clear, individualized preoperative counseling is essential to prepare patients for the potential need for revision surgery.

Strengths & limitations: This study benefits from a large sample size and long follow-up but is limited by its retrospective design and reliance on electronic records.

Conclusion: Penile inversion vulvo-vaginoplasty with scrotal skin graft is a generally safe procedure; detailed knowledge of complications supports better patient counseling and informed decision-making.

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外阴女性化手术并发症及危险因素分析：407名变性女性回顾性队列研究

背景：阴茎内翻外阴阴道成形术加上阴囊皮肤移植是变性女性生殖器女性化手术中广泛使用的技术。目的：了解生殖器女性化手术后并发症的类型和频率，并评估相关的危险因素。方法：回顾性分析2008年至2022年在里昂南方大学医院接受初级生殖器女性化手术的所有变性女性。纳入标准为年龄大于18岁，至少随访1年。数据收集自电子病历，包括人口统计学和临床特征、手术细节、术中事件、术后并发症和翻修程序。结果：研究的重点是术中、早期和术后晚期并发症的发生率，以及手术翻修的频率和类型。结果：407例患者（平均（SD）年龄38.6（12.7）岁，平均（SD） BMI 24.7），术中直肠损伤5例（1.2%）。1%的患者出现早期移植物衰竭需要翻修，23.1%的患者进行了二次翻修。晚期并发症包括直肠-新阴道瘘（0.5%）和阴道狭窄需要翻修（3.4%）。阴唇成形术是最常见的翻修手术（n = 68）。较年轻的年龄与早期修复增加有关，而BMI和吸烟无关。临床意义：明确的，个性化的术前咨询是必要的准备患者的潜在需要翻修手术。优势与局限性：本研究得益于样本量大、随访时间长，但受回顾性设计和依赖电子记录的限制。结论：阴囊植皮阴茎内翻外阴阴道成形术是一种安全的手术方法；对并发症的详细了解有助于更好地为患者提供咨询和做出明智的决策。

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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来源期刊

Sexual Medicine MEDICINE, GENERAL & INTERNAL-

CiteScore

5.40

自引率

0.00%

发文量

103

审稿时长

22 weeks

期刊介绍： Sexual Medicine is an official publication of the International Society for Sexual Medicine, and serves the field as the peer-reviewed, open access journal for rapid dissemination of multidisciplinary clinical and basic research in all areas of global sexual medicine, and particularly acts as a venue for topics of regional or sub-specialty interest. The journal is focused on issues in clinical medicine and epidemiology but also publishes basic science papers with particular relevance to specific populations. Sexual Medicine offers clinicians and researchers a rapid route to publication and the opportunity to publish in a broadly distributed and highly visible global forum. The journal publishes high quality articles from all over the world and actively seeks submissions from countries with expanding sexual medicine communities. Sexual Medicine relies on the same expert panel of editors and reviewers as The Journal of Sexual Medicine and Sexual Medicine Reviews.