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Related Concept Videos

Assessment of the Rectum and Anus01:25

Assessment of the Rectum and Anus

196
Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
196

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Vessel-sparing Excision and Primary Anastomosis
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Rectal Injury During Penile Inversion Vaginoplasty.

Talia Stark1, Kenan Celtik1, Jess Ting2

  • 1Department of Urology, Icahn School of, Medicine Mount Sinai Hospital, New York, NY.

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Summary
This summary is machine-generated.

Rectal injury during gender-affirming vaginoplasty is rare (0.89%). Prompt identification and repair by colorectal surgery can prevent rectovaginal fistulas, though vaginal stenosis remains a risk.

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Area of Science:

  • Surgical outcomes
  • Gender-affirming care
  • Reconstructive surgery

Background:

  • Rectal injury (RI) and rectovaginal fistula (RVF) are potential complications of gender-affirming vaginoplasty (GAV).
  • Understanding the incidence and management of RI is crucial for improving patient outcomes.

Purpose of the Study:

  • To evaluate the incidence, management, and outcomes of rectal injury (RI) and subsequent rectovaginal fistula (RVF) during gender-affirming vaginoplasty (GAV).

Main Methods:

  • Retrospective review of patients undergoing GAV from January 2016 to September 2022.
  • Analysis of preoperative, intraoperative, and postoperative findings related to rectal injury.
  • Descriptive statistics were calculated.

Main Results:

  • Rectal injury occurred in 9 out of 1011 primary GAV cases (0.89%).
  • One patient developed a rectovaginal fistula, associated with prior perineal surgery and lack of intraoperative sigmoidoscopy.
  • Three patients (50%) who underwent full-depth GAV experienced postoperative vaginal stenosis.

Conclusions:

  • Rectal injury during GAV is uncommon in experienced hands.
  • Intraoperative identification, multilayer repair, and colorectal surgery consultation are key to preventing RVF.
  • While full-depth vaginoplasty can be completed, patients must be counseled on the risk of vaginal stenosis.