Operative Management of Complications Following Intestinal Vaginoplasty: A Case Series and Systematic Review

Area of Science:

• Surgical Management
• Gender-Affirming Surgery
• Gastrointestinal Surgery

Background:

• Intestinal vaginoplasty is a complex gender-affirming surgical procedure.
• Complications can arise, necessitating further operative intervention.
• Understanding these complications is vital for patient outcomes.

Purpose of the Study:

• To describe the authors' experience managing complications after intestinal vaginoplasty.
• To review the incidence of complications following gender-affirming intestinal vaginoplasty in the literature.

Main Methods:

• Retrospective chart review of patients requiring operative management for complications.
• Analysis of medical history, surgical techniques, and outcomes.
• Systematic literature review of primary research on intestinal vaginoplasty complications.

Main Results:

• Four patients underwent surgical revision for complications including vaginal stenosis, false passage, and diversion colitis.
• Literature review identified 654 vaginoplasties with a 33% overall complication rate.
• Common complications included stenosis, mucorrhea, prolapse, and malodor; severe complications like flap loss and mortality were also reported.

Conclusions:

• Intestinal vaginoplasty is linked to various complications such as vaginal stenosis, mucorrhea, and prolapse.
• Intra-abdominal issues like diversion colitis can be severe, life-threatening, and occur years post-surgery.
• Prompt diagnosis and management are essential for adverse events following intestinal vaginoplasty.