Stoehr Jenna R, Moss Civanni, A Hamidian Jahromi
Department of Plastic and Reconstructive Surgery, University of South Florida, Tampa, Florida, USA.
Department of Plastic and Reconstructive Surgery, Temple University Hospitals, Philadelphia, Pennsylvania, USA.
Int J Transgend Health. 2023 Jul 27;25(4):623-633. doi: 10.1080/26895269.2023.2237014. eCollection 2024.
: Vaginoplasty is performed to create a neovagina for transgender individuals who seek surgical transition or for cisgender individuals with congenital or acquired absence of a vagina (or "cisvagina"). The current knowledge of the bacterial microenvironment of the neovagina is limited. The objective of this study was to conduct a systematic review of current knowledge regarding the microbiome of the neovagina in transgender women. : A systematic review of three medical databases (PubMed, MEDLINE, Web of Science) was performed in December 2021. Articles were included if they discussed the bacterial flora of the post-surgical neovagina in transgender women. Articles were excluded if their primary focus was pathogenic disease of the neovagina. Articles were summarized qualitatively and organized into a table. : Ten articles were identified for the review. Surgical techniques included penile inversion vaginoplasty (PIV) and intestinal/sigmoid vaginoplasty. PIV neovaginas were most similar to cisvaginas with bacterial vaginosis, whereas intestinal vaginoplasty resulted in microbiomes comparable to that of the colorectum. Oral probiotic supplements may be able to encourage the growth of Lactobacillus in the neovagina. Maintenance protocols relating to cleaning are largely surgeon- and institution-dependent, and evidence regarding the use of estrogen and its effect on the neovagina is limited. : The microbiome of the neovagina is distinct from that of the cisvagina, and it differs based on surgical technique. Further research is warranted to better characterize the effect of different surgical techniques, patient characteristics, estrogen use, and cleaning habits on the health of the neovaginal microbiome.
阴道成形术是为寻求手术转变的跨性别者或先天性或后天性无阴道的顺性别者（或“顺式阴道”）创建一个新阴道。目前对新阴道细菌微环境的了解有限。本研究的目的是对有关跨性别女性新阴道微生物群的现有知识进行系统综述。2021年12月对三个医学数据库（PubMed、MEDLINE、科学网）进行了系统综述。如果文章讨论了跨性别女性术后新阴道的细菌菌群，则纳入研究。如果文章主要关注新阴道的致病疾病，则将其排除。对文章进行定性总结并整理成表格。共识别出10篇文章进行综述。手术技术包括阴茎倒置阴道成形术（PIV）和肠道/乙状结肠阴道成形术。PIV新阴道与患有细菌性阴道病的顺式阴道最为相似，而肠道阴道成形术导致的微生物群与结肠直肠的微生物群相当。口服益生菌补充剂可能能够促进新阴道中乳酸杆菌的生长。与清洁相关的维护方案在很大程度上取决于外科医生和机构，关于雌激素的使用及其对新阴道的影响的证据有限。新阴道的微生物群与顺式阴道的微生物群不同，并且因手术技术而异。有必要进行进一步的研究，以更好地描述不同手术技术、患者特征、雌激素使用和清洁习惯对新阴道微生物群健康的影响。
