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Bowel vaginoplasty: a systematic review.

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Journal of Plastic Surgery and Hand Surgery
|July 25, 2018
PubMed
Summary

Bowel vaginoplasty offers a safe and effective method for neovagina construction in transgender individuals and those with vaginal aplasia, yielding excellent long-term results without routine dilatation. Further research is recommended to enhance study methodologies.

Keywords:
Vaginoplastybowelileumintestinalneovaginasigmoid

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Area of Science:

  • Surgical Reconstruction
  • Genitourinary Surgery
  • Gender Affirming Surgery

Background:

  • Neovagina construction is a key procedure for male-to-female transgender individuals and patients with vaginal aplasia.
  • Bowel vaginoplasty is a recognized surgical technique with reported positive outcomes.

Purpose of the Study:

  • To systematically review the outcomes of bowel vaginoplasty procedures.
  • To assess the quality of evidence for studies reporting on bowel vaginoplasty.
  • To evaluate the effectiveness and safety of bowel vaginoplasty for neovagina creation.

Main Methods:

  • Systematic literature search conducted in PubMed, Medline, Cochrane Library, and SveMed+ (January 2016 - February 2018).
  • Inclusion criteria based on the PICOS approach (patients, intervention, comparator, outcomes, study design).
  • Quality of evidence assessed using GRADE; methodology rated by MINORS. 34 studies met inclusion criteria from 251 analyzed.

Main Results:

  • All included studies were non-randomized with a high risk of bias and very low quality of evidence (GRADE).
  • Bowel vaginoplasty results in a self-lubricating neovagina with low failure and revision rates, eliminating the need for routine dilatation.
  • Laparoscopic techniques improve postoperative cosmetic appearance and reduce hospital stay.

Conclusions:

  • Bowel segment vaginoplasty is a safe and effective procedure for neovagina creation, demonstrating excellent long-term results.
  • The procedure provides functional and satisfactory outcomes for patients requiring vaginal reconstruction.
  • Further research with improved methodology, larger cohorts, and standardized outcome measures (e.g., Female Sexual Function Index) is warranted.