Wenk M J, Rademacher N, Liedl B, Grüne B, Meister B
Department of Urology and Urological Surgery, University Medical Center Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Center of Reconstructive Urogenital Surgery, Urologische Klinik Planegg, Planegg, Germany.
World J Urol. 2025 Sep 2;43(1):529. doi: 10.1007/s00345-025-05887-9.
To prospectively evaluate patient and clinician reported outcomes of sexual function and health-related quality of life (QOL) of transgender women preoperatively (t0), 6 months (t1), and 12 months (t2) after gender-affirming surgery (GAS) with penile inversion vaginoplasty.
Transgender women undergoing two-stage GAS at our tertiary care center were included (04/2019-01/2023). Patients received a composed questionnaire including a validated questionnaire (SF-12). Clinical outcomes and adverse events were evaluated. A regression analysis was performed to identify possible risk factors for a deterioration in sexual function and QOL.
Fifty-three patients with an average age of 40.27 ± 14.43 years were included. Complications were mostly minor (Clavien Dindo Classification grade I/II). The depth of the neovagina postoperatively was 11.98 ± 2.19 cm and the width 3.44 ± 0.98 cm. 79.4% of patients were able to experience an orgasm 12 months postoperatively. Orgasm quality increased significantly over the measurement time points (p = 0.003). The SF-12 average physical and mental scores of our collective were similar to the German populations average scores with no significant differences between the time measurement points (p = 0.405 and p = 0.198, respectively). The mental score was always lower than the physical score. A multiple linear regression analysis showed age < 40 years to be a significant influence factor regarding the physical QOL-score (p = 0.048) and the ability to experience an orgasm (p = 0.026).
Penile inversion vaginoplasty is a safe procedure that yields favorable outcomes regarding sexual function and health-related QOL. Younger age significantly predicts improved physical QOL and the ability to experience orgasm postoperatively.
前瞻性评估接受阴茎倒置阴道成形术的变性女性在性别确认手术（GAS）术前（t0）、术后6个月（t1）和12个月（t2）时患者和临床医生报告的性功能及健康相关生活质量（QOL）结果。
纳入在我们三级医疗中心接受两阶段GAS的变性女性（2019年4月至2023年1月）。患者接受一份综合问卷，其中包括一份经过验证的问卷（SF - 12）。评估临床结果和不良事件。进行回归分析以确定性功能和生活质量恶化的可能风险因素。
纳入53例平均年龄为40.27±14.43岁的患者。并发症大多为轻微（Clavien - Dindo分类I/II级）。术后新阴道深度为11.98±2.19 cm，宽度为3.44±0.98 cm。79.4%的患者术后12个月能够体验性高潮。性高潮质量在测量时间点上显著提高（p = 0.003）。我们研究群体的SF - 12平均身体和心理得分与德国人群平均得分相似，在时间测量点之间无显著差异（分别为p = 0.405和p = 0.198）。心理得分始终低于身体得分。多元线性回归分析显示年龄<40岁是身体生活质量得分（p = 0.048）和体验性高潮能力（p = 0.026）的显著影响因素。
阴茎倒置阴道成形术是一种安全的手术，在性功能和健康相关生活质量方面产生良好结果。较年轻的年龄显著预示术后身体生活质量改善和体验性高潮的能力提高。
