Division of Plastic Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
Jacob's School of Medicine and Biomedical Sciences, University at Buffalo, SUNY, Buffalo, NY, USA.
Biomed Res Int. 2018 May 10;2018:4907208. doi: 10.1155/2018/4907208. eCollection 2018.
Many techniques have been described for reconstruction of the vaginal canal for oncologic, traumatic, and congenital indications. An increasing role exists for these procedures within the transgender community. Most often, inverted phallus skin is used to create the neovagina in transwomen. However, not all patients have sufficient tissue to achieve satisfactory depth and those that do must endure cumbersome postoperative dilation routines to prevent contracture. In selected patients, the sigmoid colon can be used to harvest ample tissue while avoiding the limitations of penile inversion techniques.
Records were retrospectively reviewed for all transwomen undergoing primary sigmoid vaginoplasty with the University of Miami Gender Reassignment service between 2014 and 2017.
Average neovaginal depth was 13.9 +/- 2.0 centimeters in 12 patients. 67% were without complications, and all maintained tissue conducive to sexual activity. No incidences of bowel injury, anastomotic leak, sigmoid necrosis, prolapse, diversion neovaginitis, dyspareunia, or excessive secretions had occurred at last follow-up.
Sigmoid vaginoplasty is a reliable technique for achieving a satisfactory vaginal depth that is sexually functional. Using a collaborative approach, it is now our standard of care to offer this surgery to transwomen with phallus length less than 11.4 centimeters.
许多技术已被描述用于重建阴道腔，用于治疗肿瘤、创伤和先天性疾病。在跨性别群体中，这些手术的应用越来越多。在跨性别女性中，最常用的方法是使用倒置的阴茎皮肤来创建新阴道。然而，并非所有患者都有足够的组织来达到满意的深度，而且那些有足够组织的患者必须忍受繁琐的术后扩张程序以防止收缩。在选定的患者中，可以使用乙状结肠来获取充足的组织，同时避免阴茎反转技术的限制。
回顾性分析了 2014 年至 2017 年期间在迈阿密大学性别重置服务中心接受原发性乙状结肠阴道成形术的所有跨性别女性的记录。
12 名患者的平均新阴道深度为 13.9 +/- 2.0 厘米。67%的患者没有并发症，所有患者的组织都适合进行性行为。在最后一次随访时，没有发生肠损伤、吻合口漏、乙状结肠坏死、脱垂、转流新阴道炎、性交困难或过度分泌等并发症。
乙状结肠阴道成形术是一种可靠的技术，可以达到满意的阴道深度，具有性功能。通过协作的方法，我们现在将该手术作为阴茎长度小于 11.4 厘米的跨性别女性的标准治疗方法。
