Huayllani Maria T, Boczar Daniel, Saleem Humza Y, Cinotto Gabriela, Avila Francisco R, Manrique Oscar J, Ciudad Pedro, Rinker Brian D, Forte Antonio J
Division of Plastic Surgery, Mayo Clinic, Jacksonville, Florida, USA.
Department of Surgery, Mayo Clinic, Jacksonville, Florida, USA.
Ann Transl Med. 2021 Apr;9(7):608. doi: 10.21037/atm-20-3514.
Phalloplasty is the main treatment for gender dysphoria disorder. It is difficult to ascertain if staging of phalloplasty influences the rate of complications. We aim to describe and compare the rates of complication between single versus two-stage phalloplasty for transgender female-to-male patients. PubMed, Ovid Medline, EMBASE and SCOPUS databases were queried for studies reporting complications of female-to-male transgender patients who underwent phalloplasty. The keywords "phalloplasty", "female to male", "outcome", "complication" and synonyms in different combinations were used for the search. Only studies that could identify whether phallic shaft creation was performed in a single or two-stage procedure were included. From a total of 336 articles, 20 met the inclusion criteria. Sixteen studies reported complications associated with a single-stage phalloplasty and seven studies identified complications after a two-stage procedure. The most common complications found for both groups of staging were fistula, stricture and total/partial flap necrosis. Patients who underwent two-stage phalloplasty had higher complication rates (partial or total flap necrosis and fistulas), compared with the single-stage procedure (P<0.05). In conclusion, this systematic review identified the impact of staging in the rate of complications related to phalloplasty for transgender female-to-male patients; a two-stage phalloplasty has a higher rate of complications.
阴茎成形术是性别焦虑症的主要治疗方法。很难确定阴茎成形术的分期是否会影响并发症的发生率。我们旨在描述和比较变性女性转男性患者单期与两期阴茎成形术的并发症发生率。我们在PubMed、Ovid Medline、EMBASE和SCOPUS数据库中查询了报告接受阴茎成形术的女性转男性变性患者并发症的研究。搜索使用了“阴茎成形术”、“女性转男性”、“结果”、“并发症”以及不同组合的同义词。仅纳入能够确定阴茎体构建是采用单期还是两期手术的研究。在总共336篇文章中，20篇符合纳入标准。16项研究报告了与单期阴茎成形术相关的并发症，7项研究确定了两期手术后的并发症。两组分期中最常见的并发症是瘘管、狭窄和部分/全部皮瓣坏死。与单期手术相比，接受两期阴茎成形术的患者并发症发生率更高（部分或全部皮瓣坏死和瘘管）（P<0.05）。总之，本系统评价确定了分期对变性女性转男性患者阴茎成形术相关并发症发生率的影响；两期阴茎成形术的并发症发生率更高。
