Arda Ersan, Arıkan Mehmet Gürkan, Top Hüsamettin
Department of Urology, School of Medicine, Trakya University, Edirne, Turkey.
Department of Plastic and Reconstructive Surgery, School of Medicine, Trakya University, Edirne, Turkey.
Transgend Health. 2023 Dec 13;8(6):558-565. doi: 10.1089/trgh.2021.0003. eCollection 2023 Dec.
The aim of this study was to share our outcomes, including complications and their management, of a "modified" penile inversion vaginoplasty (PIV) technique applied to transgender individuals, which we presume to be the first reported case series of a single center from Turkey.
A cross-sectional study, including adult transgender cases who underwent male to female gender-affirming surgery in our institution, between January 2015 and December 2019, was planned. The same "modified" PIV technique, in which the spatulated urethra was incorporated to the penile skin flap, was applied to all cases. Demographic data including case characteristics, medical history with prior operative details, and complications detected during follow-up examination were collected prospectively.
The mean age of 30 cases included in the study was 31.03±7.05 years. The mean length of hospitalization after the surgical procedures was 10.13±2.24 days. The mean vaginal depth measured at postoperative 1st year follow-up examination was 14.2±2.95 cm. Satisfactory neovaginal moistening was reported by 24 (80%) cases. In 8 (26.6%) of 30 cases, no complication was reported at all. Intraoperative (rectal injury) and postoperative (meatal stenosis, vaginal narrowing, scars, infections, etc.) complications occurred in 22 (63.4%) cases. Postoperative satisfaction rates including mental, physical, and social health in general were found to be 81.84% (66-98%).
The "modified" PIV can be used as a preferred technique showing high satisfactory outcomes, especially in cases with short penile skin or circumcision, due to the achievable lubricity and vaginal width/depth.
本研究的目的是分享我们将一种“改良”阴茎翻转阴道成形术（PIV）应用于跨性别者的结果，包括并发症及其处理，我们推测这是土耳其单中心首个报道的病例系列。
计划进行一项横断面研究，纳入2015年1月至2019年12月在我们机构接受男性向女性性别确认手术的成年跨性别病例。所有病例均采用相同的“改良”PIV技术，即将铲状尿道纳入阴茎皮瓣。前瞻性收集包括病例特征、既往手术细节的病史以及随访检查中发现的并发症等人口统计学数据。
本研究纳入的30例患者的平均年龄为31.03±7.05岁。手术操作后的平均住院时间为10.13±2.24天。术后第1年随访检查时测得的平均阴道深度为14.2±2.95厘米。24例（80%）报告新阴道湿润情况良好。30例中有8例（26.6%）完全未报告并发症。22例（63.4%）发生术中（直肠损伤）和术后（尿道口狭窄、阴道狭窄、瘢痕、感染等）并发症。总体上术后包括心理、身体和社会健康方面的满意度为81.84%（66 - 98%）。
由于可实现的润滑性以及阴道宽度/深度，“改良”PIV可作为一种首选技术，尤其在阴茎皮肤短或行过包皮环切术的病例中显示出高满意度结果。
