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Vaginal Cuff Dehiscence in Transgender Patients After Minimally Invasive Hysterectomy
Reed M O'Connor1, Marla E Scott2, B J Rimel2
1Department of Obstetrics and Gynecology (Dr. O'Connor), Cedars-Sinai Medical Center, Los Angeles, CA.
Journal of Minimally Invasive Gynecology
|November 4, 2023
Summary
Transgender patients undergoing minimally invasive hysterectomy (MIH) may face a higher risk of vaginal cuff dehiscence (VCD). While not statistically significant in this study, spontaneous VCD cases were noted in transgender individuals, suggesting potential links to testosterone therapy or younger age.
Area of Science:
- Surgical outcomes
- Transgender health
- Gynecology
Background:
- Minimally invasive hysterectomy (MIH) is a common procedure.
- Vaginal cuff dehiscence (VCD) is a rare but serious complication.
- Understanding VCD risk factors in diverse patient populations is crucial.
Purpose of the Study:
- To compare the incidence of vaginal cuff dehiscence (VCD) in transgender versus cisgender patients after minimally invasive hysterectomy (MIH).
- To identify potential risk factors associated with VCD in transgender patients undergoing MIH.
Main Methods:
- Retrospective cohort analysis of 166 patients undergoing MIH.
- Comparison of VCD rates between transgender patients (n=49) and cisgender patients (n=117).
- Assessment of demographics, surgical details, and dehiscence events.
Main Results:
- VCD occurred in 6.1% of transgender patients versus 1.7% of cisgender patients (p > 0.05).
- Transgender patients were younger and more likely to be on testosterone therapy.
- Dehiscence in transgender patients was spontaneous, while cisgender cases had identifiable precipitating factors.
Conclusions:
- Transgender patients may have an increased risk of VCD after MIH.
- Testosterone therapy and younger age are potential risk factors for VCD in this population.
- Further research with biospecimen analysis is needed to explore cellular differences.
