Department of Obstetrics and Gynecology, the Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, and the Department of Pathology, Anatomy, & Cell Biology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Obstet Gynecol. 2021 Jul 1;138(1):51-57. doi: 10.1097/AOG.0000000000004421.
To describe the clinical characteristics of transmasculine individuals who underwent hysterectomy and characterize surgical pathology findings.
Under an institutional review board-approved protocol, transmasculine individuals who were undergoing hysterectomy and bilateral salpingectomy or bilateral salpingo-oophorectomy were retrospectively identified from a single institution. Past medical, surgical, obstetric, and gynecologic history were collected, including prior testosterone use, cervical cancer screening status, and preoperative pelvic imaging. Surgical pathologic findings of the endometrium, ovaries, and cervix were collected.
A total of 72 individuals were included. The median age was 30 years (range 19-51). The majority of patients had private insurance (n=53, 74%) and were on testosterone at time of the preoperative visit (n=63, 88%). Forty-two patients (58%) reported anxiety, depression, or bipolar disorder, and 34 patients (47%) were taking an antidepressant or mood stabilizer. Of the 68 patients eligible for cervical cancer screening, 33 (49%) were up to date before their surgical consultation visits. Pelvic pain was the leading indication for surgery (n=65, 90%), and 29 patients (40%) had multiple listed indications for surgery. Surgical pathology results included cervical intraepithelial neoplasia 2-3 in three patients (4%), endometrial or cervical atrophy in 13 patients (18%), and ovarian or paratubal cysts in 16 patients (22%).
This study describes the distinct clinical characteristics and surgical pathology findings that health care professionals should consider when caring for this unique patient population, including a relatively high rate of mental health conditions, pelvic pain as the leading indication for surgery, and the presence of endometrial or cervical atrophy and ovarian or paratubal cysts on surgical pathology.
描述接受子宫切除术的跨性别男性个体的临床特征，并描述手术病理发现。
根据机构审查委员会批准的方案，从一家医疗机构回顾性确定接受子宫切除术和双侧输卵管切除术或双侧输卵管卵巢切除术的跨性别男性个体。收集了过去的医疗、手术、产科和妇科病史，包括先前使用睾丸酮、宫颈癌筛查状况和术前盆腔影像学检查。收集了子宫内膜、卵巢和宫颈的手术病理发现。
共纳入 72 名个体。中位年龄为 30 岁（范围 19-51）。大多数患者拥有私人保险（n=53，74%），且在术前就诊时正在使用睾丸酮（n=63，88%）。42 名患者（58%）报告有焦虑、抑郁或双相情感障碍，34 名患者（47%）正在服用抗抑郁药或情绪稳定剂。在 68 名有资格进行宫颈癌筛查的患者中，33 名（49%）在手术咨询就诊前已完成筛查。盆腔疼痛是手术的主要指征（n=65，90%），29 名患者（40%）有多种手术指征。手术病理结果包括 3 名患者（4%）有宫颈上皮内瘤变 2-3 级，13 名患者（18%）有子宫内膜或宫颈萎缩，16 名患者（22%）有卵巢或副输卵管囊肿。
本研究描述了医疗保健专业人员在照顾这一独特患者群体时应考虑的独特临床特征和手术病理发现，包括相对较高的心理健康状况发生率、盆腔疼痛作为手术的主要指征，以及手术病理上存在子宫内膜或宫颈萎缩和卵巢或副输卵管囊肿。
