Ramona Osswald, Anna-Sophie Villiger, Giovanni Ruggeri, Diana Hoehn, Michael Mueller, Annette Kuhn
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引用次数: 0
Abstract
Introduction and hypothesis: Various techniques for neovagina creation have been developed and refined. The aim of this study was to evaluate the incidence of prolapse and possible consecutive therapies in transfemale patients who have received a neovagina as part of their sex reassignment surgery (SRS).
Methods: This prospective single-centre case control study was performed at Bern University Hospital (Department of Gynaecology) between 2017 and 2023. Sixty-eight patients who had received SRS (all male to female) were undergoing regular gynaecologic examinations assessing the ICS-Pelvic Organ Prolapse Staging (POP-Q score) and VAS score for symptom burden. Appropriate management for prolapse correction was initiated. Linear and logistic regression were employed for the average comparison of the parameters in correlation to the type of sex reassignment surgery applied.
Results: Fifty-four of the 68 participant patients had undergone penis-scrotum inversion technique, six had a neovagina created by peritoneum and seven had an intestinal neovagina. Mean follow-up was 27.5 years. Thirteen patients (19.4%) experienced genital prolapse in this cohort. The group after peritoneal neovagina surgery demonstrated the highest odds ratio for rectocele (OR 4.9, p = 0.17 95% CI 0.71-33.78) and vaginal prolapse (OR 16.67, p = 0.005 95% CI 2.3-120.65). Statistically significant differences in all POP-Q parameters for the penile inversion group indicate smaller vaginal prolapse. Prolapse surgery significantly decreased the VAS score (p < 0.001; 95% CI 5.92-8.38).
Conclusions: One in five transfemale patients who have undergone sex reassignment surgery experience genital prolapse. The prevalence of prolapse was found to be highest in the peritoneum reconstruction group, followed by the patients with intestinal neovagina and penile inversion. Surgical intervention for prolapse appears to significantly alleviate symptoms.
介绍和假设：各种各样的新阴道创造技术已经发展和完善。本研究的目的是评估接受新阴道手术（SRS）的变性女性患者脱垂的发生率和可能的连续治疗。方法：这项前瞻性单中心病例对照研究于2017年至2023年在伯尔尼大学医院（妇科）进行。68例接受SRS治疗的患者（均为男至女）定期接受妇科检查，评估ics -盆腔器官脱垂分期（POP-Q评分）和症状负担VAS评分。开始适当的脱垂矫正管理。采用线性和逻辑回归对相关参数与所应用的性别重置手术类型进行平均比较。结果：68例患者中54例行阴茎-阴囊倒置术，6例为腹膜性新阴道，7例为肠性新阴道。平均随访时间为27.5年。该队列中有13例患者（19.4%）出现生殖器脱垂。腹膜新阴道手术组直肠前突（OR 4.9, p = 0.17 95% CI 0.71-33.78）和阴道脱垂（OR 16.67, p = 0.005 95% CI 2.3-120.65）的优势比最高。阴茎内翻组的所有POP-Q参数差异有统计学意义，表明阴道脱垂较小。结论：接受变性手术的变性女性患者中有1 / 5出现生殖器脱垂。以腹膜重建术组脱垂发生率最高，其次为肠新阴道及阴茎内翻。手术干预脱垂似乎明显减轻症状。
期刊介绍：
The International Urogynecology Journal is the official journal of the International Urogynecological Association (IUGA).The International Urogynecology Journal has evolved in response to a perceived need amongst the clinicians, scientists, and researchers active in the field of urogynecology and pelvic floor disorders. Gynecologists, urologists, physiotherapists, nurses and basic scientists require regular means of communication within this field of pelvic floor dysfunction to express new ideas and research, and to review clinical practice in the diagnosis and treatment of women with disorders of the pelvic floor. This Journal has adopted the peer review process for all original contributions and will maintain high standards with regard to the research published therein. The clinical approach to urogynecology and pelvic floor disorders will be emphasized with each issue containing clinically relevant material that will be immediately applicable for clinical medicine. This publication covers all aspects of the field in an interdisciplinary fashion
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