Preoperative Assessment for Transmasculine Patients Undergoing Gender-Affirming Hysterectomy

Area of Science:

• Reproductive Medicine
• Surgical Oncology
• Gender-Affirming Care

Background:

• Gender-affirming hysterectomy is a key component of gender-affirming care.
• Preoperative assessment aims to optimize surgical planning and patient safety.

Purpose of the Study:

• To evaluate the impact of preoperative pelvic ultrasound findings on the surgical approach for gender-affirming hysterectomy.
• To determine if routine pelvic ultrasonography influences operative decisions in this patient population.

Main Methods:

• Retrospective cohort study including 57 patients who underwent gender-affirming hysterectomy between February 2017 and February 2024.
• Analysis of preoperative pelvic ultrasound reports for 46 patients (80.7%) within 5 years of surgery.
• Comparison of planned surgical approach with actual intraoperative management.

Main Results:

• Preoperative ultrasound reports did not lead to modifications in the planned conventional laparoscopic surgical approach.
• No patients required intraoperative conversion to alternative surgical techniques.
• All 57 patients successfully completed the procedure using the initially planned laparoscopic method.

Conclusions:

• Preoperative pelvic ultrasonography did not alter surgical management for gender-affirming hysterectomy in this cohort.
• Conventional laparoscopic hysterectomy is a safe and effective approach for this population.
• Further research may explore the utility of routine preoperative imaging in specific clinical scenarios.