Duflot Théo, Morel-Journel Nicolas, Jurek Lucie, Plainard Xavier, Delporte Gauthier, Carnicelli Damien, Marcelli François, Neuville Paul
Department of Urology, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre-Bénite Cedex, France.
Child and Adolescent Unit, Psychiatry Department, Centre Hospitalier Le Vinatier, Lyon, France.
Transgend Health. 2025 Apr 11;10(2):185-192. doi: 10.1089/trgh.2023.0047. eCollection 2025 Apr.
This study aimed to analyze the functional outcomes after vulvovaginoplasty for trans women with a comprehensive analysis, including sexual function, satisfaction, and esthetic results.
A prospective, observational, multicenter study of trans women who underwent vulvovaginoplasty between 2007 and 2019 was conducted at three different centers in France. Data collection was achieved through an online questionnaire. Participants were asked to complete a questionnaire that included the Female Sexual Function Index (FSFI), the Female Genital Self-Image Scale (FGSIS), the Body Image Scale (BIS), and nonvalidated questions to explore sexual practices, related orgasm, genital sensitivity, and specific postsurgical satisfaction.
A total of 158 women were included. Highest scores of the FSFI were obtained for the satisfaction domain, lubrication was scored the lowest. Two-thirds (64%, 89/138) of sexually active women had an FSFI score <26.5 (cutoff suggested for sexual dysfunction); the total mean±standard deviation (SD) FSFI score was 21.2±9.5. Self-image was favorable overall; the mean±SD BIS score was 4.5±5.2 and the mean±SD FGSIS score of 22.1±4.3. Masturbation was the most frequent sexual activity and the only one that led to a positive mean orgasm frequency score. The clitoris was the area women most frequently reported as having "sufficient sensitivity" (67.7%).
This multi-institutional study of functional outcomes after vulvovaginoplasty found positive esthetic outcomes and high satisfaction. More than 85% of trans women were sexually active, and sexuality was rich and common despite mixed functional results. These results enlighten the postoperative outcomes and thereby the points to discuss with women considering vulvovaginoplasty.
本研究旨在通过全面分析，包括性功能、满意度和美学效果，分析为跨性别女性进行外阴阴道成形术后的功能结局。
在法国的三个不同中心，对2007年至2019年间接受外阴阴道成形术的跨性别女性进行了一项前瞻性、观察性、多中心研究。通过在线问卷收集数据。参与者被要求完成一份问卷，其中包括女性性功能指数（FSFI）、女性生殖器自我形象量表（FGSIS）、身体形象量表（BIS），以及一些未经验证的问题，以探究性行为、相关性高潮、生殖器敏感性和特定的术后满意度。
共纳入158名女性。FSFI中满意度领域得分最高，润滑得分最低。三分之二（64%，89/138）有性活动的女性FSFI得分<26.5（性功能障碍建议的临界值）；FSFI总平均±标准差（SD）得分为21.2±9.5。总体自我形象良好；BIS平均±SD得分为4.5±5.2，FGSIS平均±SD得分为22.1±4.3。自慰是最常见的性活动，也是唯一导致平均性高潮频率得分呈阳性的活动。阴蒂是女性最常报告有“足够敏感性”的区域（67.7%）。
这项关于外阴阴道成形术后功能结局进行的多机构研究发现了良好的美学效果和高满意度。超过85%的跨性别女性有性活动，尽管功能结果不一，但性体验丰富且常见。这些结果揭示了术后结局，从而为与考虑进行外阴阴道成形术的女性讨论的要点提供了依据。
