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. 2023 Dec 13;8(6):558-565.
doi: 10.1089/trgh.2021.0003. eCollection 2023 Dec.

"Modified" Penile Inversion Vaginoplasty: First Case Series of a Turkish Single Center

Ersan Arda  1 , Mehmet Gürkan Arıkan  1 , Hüsamettin Top  2
Affiliations

"Modified" Penile Inversion Vaginoplasty: First Case Series of a Turkish Single Center

Ersan Arda et al. Transgend Health. .

Abstract

Purpose: The aim of this study was to share our outcomes, including complications and their management, of a "modified" penile inversion vaginoplasty (PIV) technique applied to transgender individuals, which we presume to be the first reported case series of a single center from Turkey.

Methods: A cross-sectional study, including adult transgender cases who underwent male to female gender-affirming surgery in our institution, between January 2015 and December 2019, was planned. The same "modified" PIV technique, in which the spatulated urethra was incorporated to the penile skin flap, was applied to all cases. Demographic data including case characteristics, medical history with prior operative details, and complications detected during follow-up examination were collected prospectively.

Results: The mean age of 30 cases included in the study was 31.03±7.05 years. The mean length of hospitalization after the surgical procedures was 10.13±2.24 days. The mean vaginal depth measured at postoperative 1st year follow-up examination was 14.2±2.95 cm. Satisfactory neovaginal moistening was reported by 24 (80%) cases. In 8 (26.6%) of 30 cases, no complication was reported at all. Intraoperative (rectal injury) and postoperative (meatal stenosis, vaginal narrowing, scars, infections, etc.) complications occurred in 22 (63.4%) cases. Postoperative satisfaction rates including mental, physical, and social health in general were found to be 81.84% (66-98%).

Conclusion: The "modified" PIV can be used as a preferred technique showing high satisfactory outcomes, especially in cases with short penile skin or circumcision, due to the achievable lubricity and vaginal width/depth.

Keywords: gender-affirming surgery; male to female; penile skin flap; transgender; urethral flap; vaginoplasty.

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Conflict of interest statement

No competing financial interests exist.

Figures

FIG. 1.
FIG. 1.
(A) Dorsally spatulated urethra with a longitudinal midline incision. (B) Inverted penile skin flap with the incorporation of the urethra that creates superior and posterior neovaginal wall.
FIG. 2.
FIG. 2.
Preservation of the glans for sensitivity.
FIG. 3.
FIG. 3.
Disassembled penile structures without the corpora cavernosa.
FIG. 4.
FIG. 4.
Fixation of the neoclitoris to the pubic bone.
FIG. 5.
FIG. 5.
Postoperative final image.
FIG. 6.
FIG. 6.
The 3rd week check-up image.
FIG. 7.
FIG. 7.
The 3rd month check-up image.
See this image and copyright information in PMC

References

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