阴茎翻转阴道成形术后危及生命的出血：病例分析与实践改进
Life-Threatening Bleeding Following Penile Inversion Vaginoplasty: Case Analysis and Practice Improvement.
作者信息
Das Rishub K, Assi Patrick E, Al Kassis Salam
机构信息
Vanderbilt University School of Medicine, Nashville, Tennessee.
Department of Plastic Surgery, Vanderbilt University Medical Center, Nashville, Tenessee.
出版信息
Eplasty. 2023 Dec 1;23:e72. eCollection 2023.
BACKGROUND
Gender-affirming surgery is a medically necessary treatment for transgender and gender diverse patients experiencing gender dysphoria. Preliminary data demonstrate an association between gender-affirming surgery and improved mental health outcomes. Penile inversion vaginoplasty is the most frequently performed feminizing bottom surgery in transwomen. Importantly, complications associated with penile inversion vaginoplasty are not uncommon and can be life-threatening. Surgeons and other members of the health care team must be aware of these potential harms. However, there is a paucity of high-quality evidence reported in the literature about the management and breadth of complications regarding feminizing bottom surgery.
CASE
A healthy 37-year-old woman who was assigned male at birth underwent gender-affirming orchiectomy, penile inversion vaginoplasty, and vulvar reconstruction. During routine vaginal packing removal in the postoperative period, there was an acute arterial bleed in the neovaginal canal, and hemostasis was achieved in the operating room.
CONCLUSIONS
We review the associated periprostatic anatomy and describe several practice improvements to mitigate postoperative complications.
背景
性别肯定手术是对患有性别焦虑症的跨性别和性别多样化患者进行的医学必要治疗。初步数据表明性别肯定手术与改善心理健康结果之间存在关联。阴茎倒置阴道成形术是跨性别女性中最常进行的女性化下体手术。重要的是，与阴茎倒置阴道成形术相关的并发症并不罕见，且可能危及生命。外科医生和医疗团队的其他成员必须意识到这些潜在危害。然而，文献中报道的关于女性化下体手术并发症的管理和范围的高质量证据很少。
病例
一名健康的37岁女性，出生时被指定为男性，接受了性别肯定性睾丸切除术、阴茎倒置阴道成形术和外阴重建术。术后在常规取出阴道填塞物时，新阴道管出现急性动脉出血，并在手术室实现了止血。
结论
我们回顾了相关的前列腺周围解剖结构，并描述了几种减少术后并发症的实践改进方法。
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