Related Experiment Video
Updated: Jun 24, 2025
08:09
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
11.4K
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.
Urology
|June 8, 2024
Summary
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.
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.
