Niggli Salome, Bausch Kathrin, Mijuskovic Barbara, Nuñez David Garcia, Vosshenrich Jan, Schaefer Dirk Johannes, Seifert Hans Helge, Feicke Antje
Medical Faculty, University of Basel, Basel, Switzerland.
Department of Urology, University Hospital Basel, Basel, Switzerland.
Transl Androl Urol. 2020 Aug;9(4):1773-1777. doi: 10.21037/tau-20-733.
This case report highlights the importance of a wide differential diagnosis in transgender patients. A 77-year-old transgender (female-to-male) with recurrent urinary tract infections (UTI) and obstructive voiding difficulties presented with a perineal cyst. Further examinations, including computed tomography (CT) and puncture, revealed that the patient had a symptomatic Bartholin gland cyst, a phenomenon that normally only affects women. In his gender confirmation surgery (GCS) 30 years before, the patient's female labia minora and Bartholin glands were used to lengthen the urethra for the phalloplasty. This explains the unusual location and the prolonged time to the correct diagnose. We decided to perform an incision of the fluid collection from perineal. A follow-up sonography after one month revealed a remaining cyst size of 6 mL, which was assumed to be residual fluid or newly produced liquid; however, the patient has not had any UTIs since the incision of the cyst. Our case seems to be the first description of a symptomatic Bartholin gland cyst in a trans man. This stresses the importance of an expanded understanding of sex/gender concepts, and underlines one of the many possible diagnostic pitfalls when treating trans people.
本病例报告强调了对 transgender 患者进行广泛鉴别诊断的重要性。一名 77 岁的 transgender（女变男）患者，反复出现尿路感染（UTI）且有排尿梗阻困难，伴有会阴部囊肿。进一步检查，包括计算机断层扫描（CT）和穿刺，发现患者患有有症状的巴氏腺囊肿，这是一种通常只影响女性的现象。在 30 年前的性别确认手术（GCS）中，患者的小阴唇和巴氏腺被用于延长尿道以进行阴茎成形术。这解释了囊肿不寻常的位置以及确诊时间的延长。我们决定对会阴部的积液进行切开引流。一个月后的超声随访显示囊肿大小为 6 mL，推测为残留液体或新产生的液体；然而，自囊肿切开以来患者未再发生任何尿路感染。我们的病例似乎是首例关于变性男性有症状巴氏腺囊肿的描述。这强调了扩大对性/性别概念理解的重要性，并突显了在治疗 transgender 人群时众多可能的诊断陷阱之一。
