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Urogenital Complications that Decrease Quality of Life in Transgender Surgery

Year 2024, Volume: 19 Issue: 1, 52 - 60, 27.02.2024

Abstract

Gender reassignment surgeries are performed not to treat a congenital or anatomical anomaly, but to treat the psychological problems of transsexuals. In fact, there is no definitive evidence showing that psychological problems in transsexuals are cured by hormonal and/or surgical treatments for gender reassignment. On the contrary, there is evidence that these psychological problems persist after medical and surgical interventions, and even increase in some transsexuals, and a new form of body dysphoria occurs in a quarter of cases. Psychological problems in transgender people are not cured by surgery, and additional surgery-related complications develop in three-quarters of the cases. The vast majority of these are urogenital complications, and more than half require reoperations. However, in a significant proportion of cases, the outcome is unsuccessful and these urogenital complications significantly reduce the quality of life of transsexuals. Data also show that the life expectancy of transsexuals who undergo surgery is shortened by an average of 25-28 years due to psychological problems, suicides, surgical complications, reoperations and diseases related to hormone use. These results have led to an increase in the number of detransitioners who regret their medical and surgical transition and want to return in recent years, and have increased ethical debates on this issue. In this article, urogenital complications that develop after transgender surgery, which reduce the quality of life and possibly play a role in regrets are summarized.

References

  • Coleman E, Radix AE, Bouman WP, et al. Arcelus J. Standards of care for the health of transgender and gender diverse people, version 8. International Journal of Transgender Health. 2022;23(Suppl 1):S1-S259. https://doi.org/10.1080/26895269.2022.2100644. 
  • Dhejne C, Lichtenstein P, Boman M et al. Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden. PLoS One. 2011;6(2):e16885. https://doi.org/10.1371/journal.pone.0016885
  • Ludvigsson JF, Adolfsson J, Hoistad M, Rydelius PA, Kristrom B, Landen M. A systematic review of hormone treatment for children with gender dysphoria and recommendations for research. Acta Paediatrica. 2023. https://doi.org/10.1111/apa.16791.
  • Carmichael, P., Butler G, Masic U, Cole TJ, De Stavola BL, Davidson S, Skageberg EM, Khadr S, & Viner RM. (2021). Short-term outcomes of pubertal suppression in a selected cohort of 12 to 15 year old young people with persistent gender dysphoria in the UK. PLoS One, 2;16(2):e0243894. https://doi.org/10.1371/journal.pone.0243894
  • National Institute of Health and Care Excellence (NICE). (2020). Evidence review: Gonadotrophin releasing hormone analogues for children and adolescents with gender dysphoria. https://cass.independent-review.uk/nice-evidence-reviews/
  • Simonsen RK, Giraldi A, Kristensen E, Hald GM. Long-term follow-up of individuals undergoing sex reassignment surgery: Psychiatric morbidity and mortality. Nord J Psychiatry. 2016;70(4):241-47. https://doi.org/10.3109/08039488.2015.1081405
  • Sansfacon AP, Gelly MA, Gravel R, Medico D, Baril A, Susset F, Paradis A. A nuanced look into youth journeys of gender transition and detransition. Infant and Child Development, 2023;e2402. https://doi.org/10.1002/icd.2402
  • Dhejne C, Van Vlerken R, Heylens G, Arcelus J. Mental health and gender dysphoria: A review of the literature. Int Rev Psychiatry. 2016;28(1):44-57. https://doi.org/10.3109/09540261.2015.1115753
  • Exposito-Campos P. A typology of gender detransition and its implications for healthcare providers. Journal of Sex and Marital Therapy. 2021;47(3):270-280. https://doi.org/10.1080/0092623X.2020.1869126
  • Irwig MS. Detransition Among Transgender and Gender-Diverse People-An Increasing and Increasingly Complex Phenomenon, June 2022, The Journal of Clinical Endocrinology and Metabolism 2022;107(4) https://doi.org/10.1210/clinem/dgac356
  • Jorgensen SCJ. Transition Regret and Detransition: Meanings and Uncertainties. Arch Sex Behav. 2023;52(5):2173-2184. https://doi.org/10.1007/s10508-023-02626-2
  • Levine SB, Abbruzzese E, Mason JW. Reconsidering informed consent for trans-identified children, adolescents, and young adults. Journal of Sex & Marital Therapy. 2022;48(7):706-727. https://doi.org/10.1080/0092623X.2022.2046221.
  • Littman L. Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners. Arch Sex Behav. 2021;50(8):3353-3369. https://doi.org/10.1007/s10508-021-02163-w
  • MacKinnon KR, Ashley F, Kia H, Lam JSH, Krakowsky Y, Ross LE. Preventing transition “regret”: An institutional ethnography of gender-affirming medical care assessment practices in Canada. Soc Sci Med. 2021;291:114477. https://doi.org/10.1371/journal.pone.0293868
  • MacKinnon KR, Expósito-Campos P, Gould WA. Detransition needs further understanding, not controversy. BMJ. 2023 Jun 14;381:e073584. https://doi.org/10.1136/bmj-2022-073584
  • Marchiano L. Gender detransition: A case study. Journal of Analytical Psychology. 2021;66(4):813-832. https://doi.org/10.1111/1468-5922.12711.
  • MacKinnon KR, Gould AW, Ashley F, Enxuga G, Kia H, Ross LE. (De)transphobia: Examining the socio-politically driven gender minority stressors experienced by people who detransitioned. Bulletin of Applied Transgender Studies. 2022;1(3):235-259. https://doi.org/10.57814/8nd4-6a89.
  • Turban JL, Loo SS, Almazan AN, Keuroghlian AS. Factors Leading to “Detransition” Among Transgender and Gender Diverse People in the United States: A Mixed-Methods Analysis. LGBT Health. 2021;8(4):273-280. https://doi.org/:10.1089/lgbt.2020.0437
  • Vandenbussche E. Detransition-Related Needs and Support: A Cross-Sectional Online Survey. J Homosex. 2022 Jul 29;69(9):1602-1620. https://doi.org/10.1080/00918369.2021.1919479
  • Block J. Gender dysphoria in young people is rising-and so is professional disagrement. BMJ. 2023;380:382. https://doi.org/10.1136/bmj.p382. 
  • Kuhn A, Bodmer C, Stadlmayr W, Kuhn P, Mueller MD, Birkhäuser M. Quality of life 15 years after sex reassignment surgery for transsexualism. Fertility and Sterility 2009;92(5):1685-89. https://doi.org/10.1016/j.fertnstert.2008.08.126
  • Kuhn A, Hiltebrand R, Birkhäuser M. Do transsexuals have micturition disorders? Eur J Obstet Gynecol Reprod Biol. 2007;131(2):226-30. https://doi.org/10.1016/j.ejogrb.2006.03.019
  • Kuhn A, Santi A, Birkhäuser M. Vaginal prolapse, pelvic floor function, and related symptoms 16 years after sex reassignment surgery in transsexuals. Fertil Steril. 2011;95(7):2379-82. https://doi.org/10.1016/j.fertnstert.2011.03.029
  • Bizic MR, Jeftovic M, Pusica S, Stojanovic B, Duisin D, Vujovic S, Rakic V, Djordjevic ML. Gender Dysphoria: Bioethical Aspects of Medical Treatment. Biomed Res Int. 2018 Jun 13;2018:9652305. https://doi.org/10.1155/2018/9652305. eCollection 2018.
  • Micallef C. The Transgender Journey and its Psychiatric Implications: A Case Observation and Comparative Analysis between Transgenderism and Clinical Lycanthropy. Int J Med. Public Health. 2022;12(3):137-145.
  • Shteyler VM, Adashi EY. Medicolegal issues surrounding legal sex designations. Fertil Steril. 2021;116(4):922-923. https://doi.org/10.1016/j.fertnstert.2021.08.020
  • Akhavan AA, Sandhu S, Ndem I, Ogunleye AA. A review of gender affirmation surgery: What we know, and what we need to know. Surgery. 2021;170(1):336-340. https://doi.org/10.1016/j.surg.2021.02.013.
  • Turan Ş, Poyraz AC, İnce E, Kani AS, Emül HM, Duran A. Sociodemographic and Clinical Characteristics of Transsexual Individuals who Applied to a Psychiatry Clinic for Sex Reassignment Surgery Türk Psikiyatri Dergisi 2015;26(3):153-60. PMID: 26364169
  • Ferrando CA. Vaginoplasty Complications. Clin Plast Surg. 2018 Jul;45(3):361-368. https://doi.org/10.1016/j.ajog.2020.05.033
  • Giovanardani G. Buying time or arresting development? The dilemma of administering hormone blockers in trans children and adolescents. Porto Biomed J 2017;2:153-56. https://doi.org/10.1016/j.pbj.2017.06.001
  • Drinane JJ, Santucci R. What urologists need to know about male to female genital confirmation surgery (vaginoplasty): techniques, complications and how to deal with them. Minerva Urol Nefrol. 2020;72(2):162-172. https://doi.org/10.23736/S0393-2249.20.03618-8
  • Papadopulos NA, Zavlin D, Lellé JD, et al. Combined vaginoplasty technique for male-to-female sex reassignment surgery: Operative approach and outcomes. J Plast Reconstr Aesthet Surg. 2017;70(10):1483-1492. https://doi.org/10.1016/j.bjps.2017.05.040
  • Horbach SER, Bouman MB, Smit JM, et al. Outcome of vaginoplasty in male-to-female transgenders: a systematic review of surgical techniques. J Sex Med 2015;12(6):1499-512. https://doi.org/10.1111/jsm.12868
  • Morrison SD, Satterwhite T, Grant DW, Kirby J, Laub DR Sr, VanMaasdam J. Long-Term Outcomes of Rectosigmoid Neocolporrhaphy in Male-to-Female Gender Reassignment Surgery. Plast Reconstr Surg. 2015 Aug;136(2):386-394. https://doi.org/10.1097/PRS.0000000000001459.
  • Santucci RA. Urethral Complications After Transgender Phalloplasty: Strategies to Treat Them and Minimize Their Occurrence. Clin Anat. 2018;31(2):187-190. https://doi.org/10.1002/ca.23021
  • Esmonde N, Bluebond-Langner R, Berli JU. Phalloplasty Flap-Related Complication. Clin Plast Surg. 2018;45(3):415-424. https://doi.org/10.1016/j.cps.2018.03.017.
  • Nikolavsky D, Hughes M, Zhao LC. Urologic Complications After Phalloplasty or Metoidioplasty. Clin Plast Surg. 2018;45(3):425-435. https://doi.org/10.1016/j.cps.2018.03.013.
  • Jun MS, Crane CN, Santucci RA. What urologists need to know about female-to-male genital confirmation surgery (phalloplasty and metoidioplasty): techniques, complications, and how to deal with them. Minerva Urol Nefrol. 2020 Feb;72(1):38-48. https://doi.org/10.23736/S0393-2249.19.03611-7
  • Morrison S, Shakir A, Vyas K, et al. Phalloplasty: a review of techniques and outcomes. Plast Reconstr Surg 2016;138(3):594-615. https://doi.org/10.1097/PRS.0000000000002518
  • Monstrey SJ, Ceulemans P, Hoebeke P. Sex Reassignment Surgery in the Female-to-Male Transsexual. Semin Plast Surg. 2011;25(3):229-44. https://doi.org/10.1055/s-0031-1281493
  • Wang AMQ, Tsang V, Mankowski P, et al. Outcomes Following Gender Affirming Phalloplasty: A Systematic Review and Meta-Analysis. Sex Med Rev 2022;10:499-512. https://doi.org/10.1016/j.sxmr.2022.03.002
  • Hu CH, Chang CJ, Wang SW, Chang KV. A systematic review and meta-analysis of urethral complications and outcomes in transgender men. J Plast Reconstr Aesthet Surg. 2022;75(1):10-24. https://doi.org/10.1016/j.bjps.2021.08.006
  • Veerman H, de Rooij FPW, Al-Tamimi M, et al. Functional Outcomes and Urological Complications after Genital Gender Affirming Surgery with Urethral Lengthening in Transgender Men. J Urol. 2020;204(1):104-109. https://doi.org/10.1097/JU.0000000000000795
  • Fascelli M, Sajadi KP, Dugi DD, Dy GW. Urinary symptoms after genital gender-affirming penile construction, urethral lengthening and vaginectomy. Transl Androl Urol. 2023 May 31;12(5):932-943. https://doi.org/10.21037/tau-22-675
  • Robinson IS, Blasdel G, Cohen O, et al. Surgical Outcomes Following Gender Affirming Penile Reconstruction: Patient-Reported Outcomes From a Multi-Center, International Survey of 129 Transmasculine Patients. J Sex Med 2021;18:800-811. https://doi.org/10.1016/j.jsxm.2021.01.183
  • Krakowsky Y, Shah G, Nguyen AV, et al. Gender-affirming care in urology: emergency care of the gender-affirming surgical patient-what the primary urologist needs to know. BJU Int. 2023 Dec 7. https://doi.org/10.1111/bju.16249.
  • Waterschoot M, Hoebeke P, Verla W, et al. Urethral Complications After Metoidioplasty for Genital Gender Affirming Surgery. J Sex Med. 2021;18(7):1271-79. https://doi.org/10.1016/j.jsxm.2020.06.023
  • Kamran R, Jackman L, Chan C, et al. Implementation of Patient-Reported Outcome Measures for Gender-Affirming Care Worldwide: A Systematic Review. JAMA Netw Open. 2023 Apr 3;6(4):e236425. https://doi.org/10.1001/jamanetworkopen.2023.6425
  • Sorensen T. A follow-up study of operated transsexual males. Acta psychiat. scand. 1981;63:486-503. https://doi.org/10.1111/j.1600-0447.1981.tb00698.x
  • Simonsen RK, Hald GM, Kristensen E, Giraldi A. Long-Term Follow-Up of Individuals Undergoing Sex-Reassignment Surgery: Somatic Morbidity and Cause of Death. Sex Med. 2016;4(1):e60-e68. https://doi.org/10.1016/j.esxm.2016.01.001

Urogenital Complications that Decrease Quality of Life in Transgender Surgery

Year 2024, Volume: 19 Issue: 1, 52 - 60, 27.02.2024

Abstract

Gender reassignment surgeries are performed not to treat a congenital or anatomical anomaly, but to treat the psychological problems of transsexuals. In fact, there is no definitive evidence showing that psychological problems in transsexuals are cured by hormonal and/or surgical treatments for gender reassignment. On the contrary, there is evidence that these psychological problems persist after medical and surgical interventions, and even increase in some transsexuals, and a new form of body dysphoria occurs in a quarter of cases. Psychological problems in transgender people are not cured by surgery, and additional surgery-related complications develop in three-quarters of the cases. The vast majority of these are urogenital complications, and more than half require reoperations. However, in a significant proportion of cases, the outcome is unsuccessful and these urogenital complications significantly reduce the quality of life of transsexuals. Data also show that the life expectancy of transsexuals who undergo surgery is shortened by an average of 25-28 years due to psychological problems, suicides, surgical complications, reoperations and diseases related to hormone use. These results have led to an increase in the number of detransitioners who regret their medical and surgical transition and want to return in recent years, and have increased ethical debates on this issue. In this article, urogenital complications that develop after transgender surgery, which reduce the quality of life and possibly play a role in regrets are summarized.

References

  • Coleman E, Radix AE, Bouman WP, et al. Arcelus J. Standards of care for the health of transgender and gender diverse people, version 8. International Journal of Transgender Health. 2022;23(Suppl 1):S1-S259. https://doi.org/10.1080/26895269.2022.2100644. 
  • Dhejne C, Lichtenstein P, Boman M et al. Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden. PLoS One. 2011;6(2):e16885. https://doi.org/10.1371/journal.pone.0016885
  • Ludvigsson JF, Adolfsson J, Hoistad M, Rydelius PA, Kristrom B, Landen M. A systematic review of hormone treatment for children with gender dysphoria and recommendations for research. Acta Paediatrica. 2023. https://doi.org/10.1111/apa.16791.
  • Carmichael, P., Butler G, Masic U, Cole TJ, De Stavola BL, Davidson S, Skageberg EM, Khadr S, & Viner RM. (2021). Short-term outcomes of pubertal suppression in a selected cohort of 12 to 15 year old young people with persistent gender dysphoria in the UK. PLoS One, 2;16(2):e0243894. https://doi.org/10.1371/journal.pone.0243894
  • National Institute of Health and Care Excellence (NICE). (2020). Evidence review: Gonadotrophin releasing hormone analogues for children and adolescents with gender dysphoria. https://cass.independent-review.uk/nice-evidence-reviews/
  • Simonsen RK, Giraldi A, Kristensen E, Hald GM. Long-term follow-up of individuals undergoing sex reassignment surgery: Psychiatric morbidity and mortality. Nord J Psychiatry. 2016;70(4):241-47. https://doi.org/10.3109/08039488.2015.1081405
  • Sansfacon AP, Gelly MA, Gravel R, Medico D, Baril A, Susset F, Paradis A. A nuanced look into youth journeys of gender transition and detransition. Infant and Child Development, 2023;e2402. https://doi.org/10.1002/icd.2402
  • Dhejne C, Van Vlerken R, Heylens G, Arcelus J. Mental health and gender dysphoria: A review of the literature. Int Rev Psychiatry. 2016;28(1):44-57. https://doi.org/10.3109/09540261.2015.1115753
  • Exposito-Campos P. A typology of gender detransition and its implications for healthcare providers. Journal of Sex and Marital Therapy. 2021;47(3):270-280. https://doi.org/10.1080/0092623X.2020.1869126
  • Irwig MS. Detransition Among Transgender and Gender-Diverse People-An Increasing and Increasingly Complex Phenomenon, June 2022, The Journal of Clinical Endocrinology and Metabolism 2022;107(4) https://doi.org/10.1210/clinem/dgac356
  • Jorgensen SCJ. Transition Regret and Detransition: Meanings and Uncertainties. Arch Sex Behav. 2023;52(5):2173-2184. https://doi.org/10.1007/s10508-023-02626-2
  • Levine SB, Abbruzzese E, Mason JW. Reconsidering informed consent for trans-identified children, adolescents, and young adults. Journal of Sex & Marital Therapy. 2022;48(7):706-727. https://doi.org/10.1080/0092623X.2022.2046221.
  • Littman L. Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently Detransitioned: A Survey of 100 Detransitioners. Arch Sex Behav. 2021;50(8):3353-3369. https://doi.org/10.1007/s10508-021-02163-w
  • MacKinnon KR, Ashley F, Kia H, Lam JSH, Krakowsky Y, Ross LE. Preventing transition “regret”: An institutional ethnography of gender-affirming medical care assessment practices in Canada. Soc Sci Med. 2021;291:114477. https://doi.org/10.1371/journal.pone.0293868
  • MacKinnon KR, Expósito-Campos P, Gould WA. Detransition needs further understanding, not controversy. BMJ. 2023 Jun 14;381:e073584. https://doi.org/10.1136/bmj-2022-073584
  • Marchiano L. Gender detransition: A case study. Journal of Analytical Psychology. 2021;66(4):813-832. https://doi.org/10.1111/1468-5922.12711.
  • MacKinnon KR, Gould AW, Ashley F, Enxuga G, Kia H, Ross LE. (De)transphobia: Examining the socio-politically driven gender minority stressors experienced by people who detransitioned. Bulletin of Applied Transgender Studies. 2022;1(3):235-259. https://doi.org/10.57814/8nd4-6a89.
  • Turban JL, Loo SS, Almazan AN, Keuroghlian AS. Factors Leading to “Detransition” Among Transgender and Gender Diverse People in the United States: A Mixed-Methods Analysis. LGBT Health. 2021;8(4):273-280. https://doi.org/:10.1089/lgbt.2020.0437
  • Vandenbussche E. Detransition-Related Needs and Support: A Cross-Sectional Online Survey. J Homosex. 2022 Jul 29;69(9):1602-1620. https://doi.org/10.1080/00918369.2021.1919479
  • Block J. Gender dysphoria in young people is rising-and so is professional disagrement. BMJ. 2023;380:382. https://doi.org/10.1136/bmj.p382. 
  • Kuhn A, Bodmer C, Stadlmayr W, Kuhn P, Mueller MD, Birkhäuser M. Quality of life 15 years after sex reassignment surgery for transsexualism. Fertility and Sterility 2009;92(5):1685-89. https://doi.org/10.1016/j.fertnstert.2008.08.126
  • Kuhn A, Hiltebrand R, Birkhäuser M. Do transsexuals have micturition disorders? Eur J Obstet Gynecol Reprod Biol. 2007;131(2):226-30. https://doi.org/10.1016/j.ejogrb.2006.03.019
  • Kuhn A, Santi A, Birkhäuser M. Vaginal prolapse, pelvic floor function, and related symptoms 16 years after sex reassignment surgery in transsexuals. Fertil Steril. 2011;95(7):2379-82. https://doi.org/10.1016/j.fertnstert.2011.03.029
  • Bizic MR, Jeftovic M, Pusica S, Stojanovic B, Duisin D, Vujovic S, Rakic V, Djordjevic ML. Gender Dysphoria: Bioethical Aspects of Medical Treatment. Biomed Res Int. 2018 Jun 13;2018:9652305. https://doi.org/10.1155/2018/9652305. eCollection 2018.
  • Micallef C. The Transgender Journey and its Psychiatric Implications: A Case Observation and Comparative Analysis between Transgenderism and Clinical Lycanthropy. Int J Med. Public Health. 2022;12(3):137-145.
  • Shteyler VM, Adashi EY. Medicolegal issues surrounding legal sex designations. Fertil Steril. 2021;116(4):922-923. https://doi.org/10.1016/j.fertnstert.2021.08.020
  • Akhavan AA, Sandhu S, Ndem I, Ogunleye AA. A review of gender affirmation surgery: What we know, and what we need to know. Surgery. 2021;170(1):336-340. https://doi.org/10.1016/j.surg.2021.02.013.
  • Turan Ş, Poyraz AC, İnce E, Kani AS, Emül HM, Duran A. Sociodemographic and Clinical Characteristics of Transsexual Individuals who Applied to a Psychiatry Clinic for Sex Reassignment Surgery Türk Psikiyatri Dergisi 2015;26(3):153-60. PMID: 26364169
  • Ferrando CA. Vaginoplasty Complications. Clin Plast Surg. 2018 Jul;45(3):361-368. https://doi.org/10.1016/j.ajog.2020.05.033
  • Giovanardani G. Buying time or arresting development? The dilemma of administering hormone blockers in trans children and adolescents. Porto Biomed J 2017;2:153-56. https://doi.org/10.1016/j.pbj.2017.06.001
  • Drinane JJ, Santucci R. What urologists need to know about male to female genital confirmation surgery (vaginoplasty): techniques, complications and how to deal with them. Minerva Urol Nefrol. 2020;72(2):162-172. https://doi.org/10.23736/S0393-2249.20.03618-8
  • Papadopulos NA, Zavlin D, Lellé JD, et al. Combined vaginoplasty technique for male-to-female sex reassignment surgery: Operative approach and outcomes. J Plast Reconstr Aesthet Surg. 2017;70(10):1483-1492. https://doi.org/10.1016/j.bjps.2017.05.040
  • Horbach SER, Bouman MB, Smit JM, et al. Outcome of vaginoplasty in male-to-female transgenders: a systematic review of surgical techniques. J Sex Med 2015;12(6):1499-512. https://doi.org/10.1111/jsm.12868
  • Morrison SD, Satterwhite T, Grant DW, Kirby J, Laub DR Sr, VanMaasdam J. Long-Term Outcomes of Rectosigmoid Neocolporrhaphy in Male-to-Female Gender Reassignment Surgery. Plast Reconstr Surg. 2015 Aug;136(2):386-394. https://doi.org/10.1097/PRS.0000000000001459.
  • Santucci RA. Urethral Complications After Transgender Phalloplasty: Strategies to Treat Them and Minimize Their Occurrence. Clin Anat. 2018;31(2):187-190. https://doi.org/10.1002/ca.23021
  • Esmonde N, Bluebond-Langner R, Berli JU. Phalloplasty Flap-Related Complication. Clin Plast Surg. 2018;45(3):415-424. https://doi.org/10.1016/j.cps.2018.03.017.
  • Nikolavsky D, Hughes M, Zhao LC. Urologic Complications After Phalloplasty or Metoidioplasty. Clin Plast Surg. 2018;45(3):425-435. https://doi.org/10.1016/j.cps.2018.03.013.
  • Jun MS, Crane CN, Santucci RA. What urologists need to know about female-to-male genital confirmation surgery (phalloplasty and metoidioplasty): techniques, complications, and how to deal with them. Minerva Urol Nefrol. 2020 Feb;72(1):38-48. https://doi.org/10.23736/S0393-2249.19.03611-7
  • Morrison S, Shakir A, Vyas K, et al. Phalloplasty: a review of techniques and outcomes. Plast Reconstr Surg 2016;138(3):594-615. https://doi.org/10.1097/PRS.0000000000002518
  • Monstrey SJ, Ceulemans P, Hoebeke P. Sex Reassignment Surgery in the Female-to-Male Transsexual. Semin Plast Surg. 2011;25(3):229-44. https://doi.org/10.1055/s-0031-1281493
  • Wang AMQ, Tsang V, Mankowski P, et al. Outcomes Following Gender Affirming Phalloplasty: A Systematic Review and Meta-Analysis. Sex Med Rev 2022;10:499-512. https://doi.org/10.1016/j.sxmr.2022.03.002
  • Hu CH, Chang CJ, Wang SW, Chang KV. A systematic review and meta-analysis of urethral complications and outcomes in transgender men. J Plast Reconstr Aesthet Surg. 2022;75(1):10-24. https://doi.org/10.1016/j.bjps.2021.08.006
  • Veerman H, de Rooij FPW, Al-Tamimi M, et al. Functional Outcomes and Urological Complications after Genital Gender Affirming Surgery with Urethral Lengthening in Transgender Men. J Urol. 2020;204(1):104-109. https://doi.org/10.1097/JU.0000000000000795
  • Fascelli M, Sajadi KP, Dugi DD, Dy GW. Urinary symptoms after genital gender-affirming penile construction, urethral lengthening and vaginectomy. Transl Androl Urol. 2023 May 31;12(5):932-943. https://doi.org/10.21037/tau-22-675
  • Robinson IS, Blasdel G, Cohen O, et al. Surgical Outcomes Following Gender Affirming Penile Reconstruction: Patient-Reported Outcomes From a Multi-Center, International Survey of 129 Transmasculine Patients. J Sex Med 2021;18:800-811. https://doi.org/10.1016/j.jsxm.2021.01.183
  • Krakowsky Y, Shah G, Nguyen AV, et al. Gender-affirming care in urology: emergency care of the gender-affirming surgical patient-what the primary urologist needs to know. BJU Int. 2023 Dec 7. https://doi.org/10.1111/bju.16249.
  • Waterschoot M, Hoebeke P, Verla W, et al. Urethral Complications After Metoidioplasty for Genital Gender Affirming Surgery. J Sex Med. 2021;18(7):1271-79. https://doi.org/10.1016/j.jsxm.2020.06.023
  • Kamran R, Jackman L, Chan C, et al. Implementation of Patient-Reported Outcome Measures for Gender-Affirming Care Worldwide: A Systematic Review. JAMA Netw Open. 2023 Apr 3;6(4):e236425. https://doi.org/10.1001/jamanetworkopen.2023.6425
  • Sorensen T. A follow-up study of operated transsexual males. Acta psychiat. scand. 1981;63:486-503. https://doi.org/10.1111/j.1600-0447.1981.tb00698.x
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There are 50 citations in total.

Details

Primary Language English
Subjects Urology
Journal Section Reviews
Authors

Zeki Bayraktar 0000-0002-2493-2457

Publication Date February 27, 2024
Submission Date October 12, 2023
Acceptance Date January 21, 2024
Published in Issue Year 2024 Volume: 19 Issue: 1

Cite

Vancouver Bayraktar Z. Urogenital Complications that Decrease Quality of Life in Transgender Surgery. New J Urol. 2024;19(1):52-60.