Barriers to Completing Preoperative Hair Removal for Penile Inversion Vaginoplasty

Area of Science:

• Gender-affirming surgery
• Dermatology
• Surgical preparation

Background:

• Penile inversion vaginoplasty (PIV) requires preoperative hair removal to prevent complications.
• Transgender patients undergo hair removal of external genitalia before PIV.
• Understanding patient experiences and barriers is essential for improving care.

Purpose of the Study:

• To assess patient progress and satisfaction with preoperative hair removal for PIV.
• To identify barriers and challenges faced by patients during the hair removal process.
• To compare the efficacy and tolerability of different hair removal modalities.

Main Methods:

• A cross-sectional survey was administered to transgender patients undergoing PIV.
• Sixty-seven patients met inclusion criteria; 46 participated (68.7% response rate).
• Data collected on hair removal methods (laser hair removal [LHR] and electrolysis), sessions, pain management, and satisfaction.

Main Results:

• Patients completed an average of two-thirds of their expected hair clearance after 14 sessions.
• Overall satisfaction with hair removal was 57.9/100, with low satisfaction in pain management (57.4/100).
• LHR was associated with significantly less procedural pain than electrolysis (p < .001). Mistreatment incidents reduced satisfaction (p = .02).

Conclusions:

• Both LHR and electrolysis are effective for preoperative hair removal in PIV.
• LHR offers better pain tolerability compared to electrolysis.
• Addressing pain management and mistreatment is crucial for improving patient satisfaction with preoperative hair removal.