Entrapped Dilator in a Male-to-Female Transgender Patient: Tips and Tricks for Device Removal

Area of Science:

• Medical Case Reports
• Surgical Procedures
• Gender Affirming Care

Background:

• Foreign body insertion into a neovagina presents unique clinical challenges.
• Male-to-female transgender individuals undergoing vaginoplasty may face complications with inserted devices.

Purpose of the Study:

• To describe a novel method for removing an entrapped vaginal dilator from a neovagina.
• To evaluate the efficacy and safety of neovaginoscopy with hydrodistention for foreign body retrieval.

Main Methods:

• A 32-year-old transgender woman presented with an entrapped vaginal dilator in her neovagina.
• Neovaginoscopy was performed under anesthesia using a hysteroscope and saline hydrodistention.
• The dilator was grasped with Pozzi forceps and removed after 800ml of saline infusion.

Main Results:

• Neovaginoscopy successfully located the impacted vaginal dilator.
• Hydrodistention facilitated the removal of the dilator by reducing friction and improving visualization.
• No urogenital fistulas or neovaginal vault rupture were identified during the procedure.

Conclusions:

• Neovaginoscopy combined with significant hydrodistention is an effective method for removing entrapped foreign bodies from a neovagina.
• This technique offers a safe and minimally invasive solution for managing such challenging cases in transgender patients.