Tondu M, Allepot K, Youkharibache A, Cristofari S
Sorbonne Université, rue de l'École-de-médecine, 75006 Paris, France.
Sorbonne Université, rue de l'École-de-médecine, 75006 Paris, France.
Ann Chir Plast Esthet. 2025 Jan;70(1):26-33. doi: 10.1016/j.anplas.2024.08.002. Epub 2024 Sep 20.
Genital gender-affirming surgery (GAS) plays a crucial role in alleviating psychological discomfort and assisting transgender patients in achieving their transition goals. One of the most common procedures for primary genital reconstruction in transwomen is penile inversion vaginoplasty. But it presents a risk of vaginal stenosis and limited depth, particularly in cases with inadequate penile and scrotal tissue. This limitation becomes more relevant as transgender individuals increasingly seek early hormone therapy and puberty blockade. We conducted a literature review focusing on studies published between 2000 and 2022 to explore the application of peritoneal vaginoplasty, a technique primarily used in cisgender women with congenital vaginal agenesis, to address these challenges in transwomen. Data were extracted from 13 selected articles reporting 313 patients who underwent peritoneal vaginoplasty. Peritoneal vaginoplasty was found to offer advantages in terms of neovaginal depth and width, with an average depth of 13.8cm and width of 3.5cm. Patient reporting satisfaction rates for sexual intercourse and dilatation achievement were high, with 96.2% and 94.4% respectively. The technique did not result in an increased rate of complications compared to traditional penile inversion vaginoplasty. This review suggests that peritoneal vaginoplasty could be consider first for transwomen genital GAS, especially in cases with limited penile tissue. The well-vascularized peritoneum provides tissue with regenerative capacities and reduces the risk of stenosis. Moreover, peritoneum remains unaffected by hormonal treatments and allows deep enough neovaginal canals. This method is safe and does not lead to increased complications compared to traditional techniques.
生殖器性别确认手术（GAS）在缓解心理不适以及帮助跨性别患者实现转变目标方面发挥着关键作用。对于跨性别女性而言，原发性生殖器重建最常见的手术之一是阴茎倒置阴道成形术。但该手术存在阴道狭窄和深度受限的风险，尤其是在阴茎和阴囊组织不足的情况下。随着跨性别者越来越多地寻求早期激素治疗和青春期阻断，这一局限性变得愈发突出。我们进行了一项文献综述，重点关注2000年至2022年间发表的研究，以探讨腹膜阴道成形术（一种主要用于先天性阴道发育不全的顺性别女性的技术）在解决跨性别女性这些挑战方面的应用。从13篇选定的文章中提取了数据，这些文章报告了313例接受腹膜阴道成形术的患者。结果发现，腹膜阴道成形术在新阴道的深度和宽度方面具有优势，平均深度为13.8厘米，宽度为3.5厘米。患者对性交和扩张效果的满意度较高，分别为96.2%和94.4%。与传统的阴茎倒置阴道成形术相比，该技术并未导致并发症发生率增加。这篇综述表明，对于跨性别女性生殖器性别确认手术，尤其是在阴茎组织有限的情况下，可首先考虑腹膜阴道成形术。血管丰富的腹膜为组织提供了再生能力，并降低了狭窄风险。此外，腹膜不受激素治疗的影响，可形成足够深的新阴道通道。与传统技术相比，这种方法是安全的，不会导致并发症增加。
