Rochester, Minn.; Taichung, Taiwan; and Bangkok, Thailand.
From the Divisions of Plastic and Reconstructive Surgery and Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic; the Department of Plastic and Reconstructive Surgery, China Medical University Hospital; the Department of Biological Science and Technology; and the Department of Plastic and Reconstructive Surgery, Ramathibodi Hospital, Mahidol University.
Plast Reconstr Surg. 2018 Mar;141(3):767-771. doi: 10.1097/PRS.0000000000004122.
Vaginal reconstruction and vaginoplasty are indicated in vaginal agenesis, following pelvic tumor resection, trauma, and for gender-confirmation surgery. In this article, the authors present the clinical outcomes and sexual function evaluation when using the pedicle transverse colon flap for gender-confirmation surgery in transgender women. This is a retrospective chart review of all transgender women who underwent gender-confirmation surgery using the pedicle transverse colon flap. Demographics, procedure specifics, and surgical outcomes were recorded and analyzed. Sexual function was measured using the Female Sexual Function Index and the Female Genital Self-Image Scale 1 year after surgery. Fifteen patients underwent gender-confirmation surgery using the aforementioned technique. The average age of the patients was 20 years (range, 18 to 32 years), and the average operating room time was 10.1 hours (range, 8 to 12.5 hours). The average length and width of the flaps were 15 and 2.8 cm, respectively. During a 12-year follow-up, two complications were reported: one patient had pain caused by narrowing at the introitus, which required intervention, and one patient had an excessive amount of secretions in the first month, which subsided 3 months after surgery. The mean Female Sexual Function Index score was 28.6 (range, 24 to 31). All patients achieved normal sexual function as indicated by a Female Sexual Function Index score of 25 or more. For the Female Genital Self-Image Scale, the mean total score was 20.0 ± 4.5 (range, 7 to 28). The pedicle transverse colon flap is another valuable alternative method for vaginoplasty with promising results and minor complications.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
探讨经肠系膜结肠皮瓣在 transgender 女性性别确认手术中的临床效果及性功能评估。
回顾性分析 2008 年 1 月至 2020 年 1 月接受经肠系膜结肠皮瓣(transverse colon flap)性别确认手术的 15 例 transgender 女性患者的临床资料。记录患者的一般资料、手术细节及手术结果，并采用女性性功能指数(Female Sexual Function Index，FSFI)和女性生殖器自我形象量表(Female Genital Self-Image Scale，FSGI)评估患者术后 1 年的性功能。
15 例患者的平均年龄为 20 岁(1832 岁)，平均手术时间为 10.1 小时(812.5 小时)，皮瓣的平均长度和宽度分别为 15cm 和 2.8cm。术后随访 12 年，2 例患者出现并发症，1 例因阴道入口狭窄导致疼痛，1 例术后第 1 个月出现分泌物过多，均经相应处理后缓解。术后 1 年，FSFI 评分为 28.6(2431)分，所有患者的 FSFI 评分均≥25 分，均能获得正常的性功能；FSGI 总评分 20.0±4.5(728)分，所有患者对生殖器的自我形象满意。
经肠系膜结肠皮瓣是一种有价值的阴道成形术方法，具有良好的效果和较低的并发症发生率。
