Madec F-X, Sabbagh P, Schirmann A, Morel-Journel N, Neuville P
Service d'urologie, hôpital Foch, Suresnes, France.
Service d'urologie, hôpital Foch, Suresnes, France.
Ann Chir Plast Esthet. 2023 Nov;68(5-6):468-476. doi: 10.1016/j.anplas.2023.08.002. Epub 2023 Aug 28.
A trans woman is a woman who was assigned male at birth, and who has a female gender identity. The majority are requesting a gender affirming genital surgery by vulvo-vaginoplasty. The objective is to review this surgery based on its history, then by presenting the different surgical techniques and their success and complication rates.
A narrative review was performed, based on a bibliography search with keywords from 2000 to 2022 on Pubmed.
Vulvo-vaginoplasty for trans women began in 1931, and the first case series date from 1969. The procedure includes excision of scrotal skin, orchiectomy, clitoroplasty, urethroplasty, labioplasty, recto-vesico-prostatic dissection and creation of a vaginal cavity (performed by penile skin inversion and graft, intestine, or peritoneum). Vulvo-vaginoplasty by penile skin inversion (VPPI) is today the reference surgical technique. It represents the vast majority of surgeries performed with the longest follow-up. The majority of trans women are satisfied with the procedure aesthetically (90%) and functionally (80%), with an active sexuality. Major complications are rare (< 5%), they correspond to fistulas or vaginal stenosis.
VPPI is the gold standard technique with satisfactory overall results, but long-term follow-up is requested.
跨性别女性是出生时被认定为男性，但具有女性性别认同的女性。大多数人要求通过外阴阴道成形术进行性别确认性生殖器手术。目的是基于其历史回顾该手术，然后介绍不同的手术技术及其成功率和并发症发生率。
基于2000年至2022年在PubMed上使用关键词进行的文献检索，进行了叙述性综述。
跨性别女性的外阴阴道成形术始于1931年，首个病例系列可追溯到1969年。该手术包括阴囊皮肤切除、睾丸切除术、阴蒂成形术、尿道成形术、阴唇成形术、直肠膀胱前列腺解剖以及创建阴道腔（通过阴茎皮肤翻转和移植、肠道或腹膜进行）。如今，阴茎皮肤翻转外阴阴道成形术（VPPI）是参考手术技术。它占所进行手术的绝大多数，随访时间最长。大多数跨性别女性在美学上（90%）和功能上（80%）对该手术满意，且具有活跃的性生活。主要并发症很少见（<5%），主要是瘘管或阴道狭窄。
VPPI是金标准技术，总体结果令人满意，但需要长期随访。
