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Reconstructive Management Pearls for the Transgender Patient
Geolani W Dy1, Jeff Sun2, Michael A Granieri2
1Department of Urology, University of Washington School of Medicine, Seattle, WA, USA.
Gender-affirming surgeries like vaginoplasty and phalloplasty are increasingly sought by transgender individuals. This review details common surgical challenges and strategies to minimize complications for better patient outcomes.
Area of Science:
- Surgical innovation in transgender healthcare
Background:
- Transgender individuals are increasingly seeking gender-affirming genital reconstructive surgery (GRS).
- These complex procedures carry a significant risk of complications.
Purpose of the Study:
- To describe common surgical pitfalls in GRS.
- To outline approaches for minimizing complications in GRS.
Main Methods:
- Review of current surgical techniques and outcomes in GRS.
- Analysis of common complications and their management strategies.
Main Results:
- Penile inversion vaginoplasty offers good cosmetic and functional results; robotic assistance may reduce rectal injury.
- Enteric vaginoplasty is an alternative for younger patients undergoing pubertal suppression.
- Microvascular techniques in phalloplasty enable sensate neophallus creation and intercourse.
- Flap coverage techniques can minimize urethral ischemia-related strictures.
- Prosthesis placement in neophallus requires anatomical adaptation.
Conclusions:
- Ongoing surgical innovation is crucial for improving outcomes in GRS.
- Addressing surgical pitfalls can enhance patient satisfaction and functional results.
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