Department of Urology, University of Michigan, Ann Arbor, MI, USA.
Department of Urology, University of Michigan, Ann Arbor, MI, USA.
Sex Med Rev. 2018 Jul;6(3):457-468.e2. doi: 10.1016/j.sxmr.2017.11.005. Epub 2018 Feb 14.
For many patients with gender dysphoria, gender-confirmation surgery (GCS) helps align their physical characteristics with their gender identity and is a fundamental element of comprehensive treatment. This article is the 2nd in a 3-part series about the treatment of gender dysphoria. Non-operative management was covered in part 1. This section begins broadly by reviewing surgical eligibility criteria, benefits of GCS, and factors associated with regret for transgender men and women. Then, the scope narrows to focus on aspects of feminizing genital GCS, including a discussion of vaginoplasty techniques, complications, and sexual function outcomes. Part 3 features operative considerations for masculinizing genital GCS.
To summarize the World Professional Association for Transgender Health's (WPATH) surgical eligibility criteria and describe how patients with gender dysphoria benefit from GCS, provide an overview of genital and non-genital feminizing gender-confirmation procedures, and review vaginoplasty techniques, preoperative considerations, complications, and outcomes.
A review of relevant literature through April 2017 was performed using PubMed.
Review of literature related to surgical eligibility criteria for GCS, benefits of GCS, and surgical considerations for feminizing genitoplasty.
Most transgender men and women who satisfy WPATH eligibility criteria experience improved quality of life, overall happiness, and sexual function after GCS; regret is rare. Penile inversion vaginoplasty is the preferred technique for feminizing genital GCS according to most surgeons, including the authors whose surgical technique is described. Intestinal vaginoplasty is reserved for certain scenarios. After vaginoplasty most patients report overall high satisfaction with their sexual function even when complications occur, because most are minor and easily treatable.
GCS alleviates gender dysphoria for appropriately selected transgender men and women. Preoperative, intraoperative, and postoperative considerations of feminizing genital gender-confirmation procedures were reviewed. Hadj-Moussa M, Ohl DA, Kuzon WM. Feminizing Genital Gender-Confirmation Surgery. Sex Med Rev 2018;6:457-468.
对于许多性别焦虑症患者来说，性别确认手术（GCS）有助于使他们的身体特征与他们的性别认同相一致，并且是综合治疗的重要组成部分。本文是关于性别焦虑症治疗的三部分系列文章中的第 2 部分。第 1 部分介绍了非手术治疗。本节从广泛审查手术资格标准、GCS 的益处以及与跨性别男性和女性后悔相关的因素开始。然后，范围缩小到专注于女性化生殖器 GCS 的各个方面，包括阴道成形术技术、并发症和性功能结果的讨论。第 3 部分介绍了男性化生殖器 GCS 的手术注意事项。
总结世界专业协会对跨性别健康（WPATH）的手术资格标准，并描述患有性别焦虑症的患者如何从 GCS 中受益，概述女性化生殖器性别确认程序，并审查阴道成形术技术、术前考虑因素、并发症和结果。
通过 PubMed 对截至 2017 年 4 月的相关文献进行了回顾。
审查与 GCS 手术资格标准、GCS 益处以及女性化生殖器整形术相关的文献。
满足 WPATH 资格标准的大多数跨性别男性和女性在 GCS 后经历生活质量、整体幸福感和性功能改善；后悔很少见。根据大多数外科医生的说法，包括描述手术技术的作者，阴茎反转阴道成形术是女性化生殖器 GCS 的首选技术。肠阴道成形术保留用于某些情况。阴道成形术后，大多数患者报告说，即使出现并发症，他们对性功能的总体满意度也很高，因为大多数并发症是轻微且易于治疗的。
GCS 缓解了适当选择的跨性别男性和女性的性别焦虑症。审查了女性化生殖器性别确认手术的术前、术中和术后注意事项。Hadj-Moussa M、Ohl DA、Kuzon WM。女性化生殖器性别确认手术。性医学评论 2018；6：457-468.
