Literature DB >> 28256903

MR imaging in patients with male-to-female sex reassignment surgery: postoperative anatomy and complications.

Michele Bertolotto1, Giovanni Liguori2, Stefano Bucci2, Mariano Iannelli1, Francesca Vedovo2, Nicola Pavan2, Carlo Trombetta2, Lorenzo E Derchi3.   

Abstract

OBJECTIVE: To investigate the role of MRI in the evaluation of both the new female anatomy and complications in male-to-female sex reassignment surgery (MtF-SRS).
METHODS: 71 consecutive patients with MtF-SRS had 74 MRI [age range, 21-63 years; mean (±standard deviation) age, 36 ± 10 years; median age, 37 years]. In 47 patients, MRI was performed to rule out early post-operative complications after gender conversion (n = 40), vaginoplasty (n = 6) or remodelling of the labia majora (n = 1). In 27 patients, MRI was performed 1-20 years after MtF-SRS for late post-operative complications, pain or dysuria, inflammatory changes or poor cosmetic outcome. Three patients had MRI both before and after the operation.
RESULTS: MRI allowed investigation of the new female anatomy in all cases. Soon after MtF-SRS, a small amount of blood was identified in all patients around the neoclitoris, urethral plaque and labia. Post-operative complications were clinically significant fluid collections (n = 5), labial abscesses (n = 2), severe cellulitis (n = 3), partial neovaginal prolapse (n = 3), focal necrosis and dehiscence of the vaginal wall (n = 2) and hypovascularization of the neoclitoris (n = 1). After ileal vaginoplasty, three patients developed clinically insignificant haematomas, one a large rectovaginal fistula with dehiscence of the intestinal anastomosis and bowel perforation (n = 1). In the 27 patients investigated 1-20 years after MfF-SRS, MRI demonstrated cavernosal remnants (n = 10), spared testis (n = 1) neovaginal strictures (n = 8), fistulas and abscesses (n = 3) and prolapse (n = 2). Three of these patients also had fibrotic changes. In the remaining three patients, no pathological features were identified.
CONCLUSION: After genital reconfiguration, MRI allows assessment of the post-operative anatomy and of post-operative complications. Advances in knowledge: Imaging features of the new anatomy and of surgical complications after SRS are discussed and illustrated.

Entities:  

Mesh:

Year:  2017        PMID: 28256903      PMCID: PMC5605084          DOI: 10.1259/bjr.20170062

Source DB:  PubMed          Journal:  Br J Radiol        ISSN: 0007-1285            Impact factor:   3.039


  14 in total

Review 1.  Vaginal reconstruction.

Authors:  T W Hensle; D T Chang
Journal:  Urol Clin North Am       Date:  1999-02       Impact factor: 2.241

2.  Sparing a testis during vaginoplasty in male-to-female transsexuals: does it benefit our patients?

Authors:  J J Hage; R B Karim; P J van Diest
Journal:  Plast Reconstr Surg       Date:  2001-06       Impact factor: 4.730

3.  Value of magnetic resonance imaging in the evaluation of sex-reassignment surgery in male-to-female transsexuals.

Authors:  M Cova; E Mosconi; G Liguori; S Bucci; C Trombetta; E Belgrano; R Pozzi-Mucelli
Journal:  Abdom Imaging       Date:  2003 Sep-Oct

4.  Male to female gender reassignment: modified surgical technique for creating the neoclitoris and mons veneris.

Authors:  Marcello Soli; Eugenio Brunocilla; Alessandro Bertaccini; Fabiano Palmieri; Barbara Barbieri; Giuseppe Martorana
Journal:  J Sex Med       Date:  2007-10-23       Impact factor: 3.802

5.  Transverse retubularized ileal vaginoplasty: a new application of the Monti principle--preliminary report.

Authors:  C Trombetta; G Liguori; S Siracusano; M Bortul; E Belgrano
Journal:  Eur Urol       Date:  2005-06-04       Impact factor: 20.096

6.  Radiological evaluation by magnetic resonance of the 'new anatomy' of transsexual patients undergoing male to female sex reassignment surgery.

Authors:  E Brunocilla; M Soli; A Franceschelli; R Schiavina; M Borghesi; G Gentile; C V Pultrone; G Martorana; M G Orrei; F Colombo
Journal:  Int J Impot Res       Date:  2012-06-07       Impact factor: 2.896

7.  Radiological evaluation of vaginal width and depth in male-to-female transsexuals by the use of magnetic resonance imaging.

Authors:  C Trombetta; G Liguori; S Bucci; L Salamè; G Garaffa; M Cova; E Belgrano
Journal:  World J Urol       Date:  2004-08-18       Impact factor: 4.226

Review 8.  Intestinal vaginoplasty revisited: a review of surgical techniques, complications, and sexual function.

Authors:  Mark-Bram Bouman; Michiel C T van Zeijl; Marlon E Buncamper; Wilhelmus J H J Meijerink; Ad A van Bodegraven; Margriet G Mullender
Journal:  J Sex Med       Date:  2014-04-04       Impact factor: 3.802

Review 9.  An overview of neovaginal reconstruction options in male to female transsexuals.

Authors:  Marta Bizic; Vladimir Kojovic; Dragana Duisin; Dusan Stanojevic; Svetlana Vujovic; Aleksandar Milosevic; Gradimir Korac; Miroslav L Djordjevic
Journal:  ScientificWorldJournal       Date:  2014-05-26

10.  Neovaginal prolapse in male-to-female transsexuals: an 18-year-long experience.

Authors:  Stefano Bucci; Giorgio Mazzon; Giovanni Liguori; Renata Napoli; Nicola Pavan; Susanna Bormioli; Giangiacomo Ollandini; Bernardino De Concilio; Carlo Trombetta
Journal:  Biomed Res Int       Date:  2014-05-07       Impact factor: 3.411

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  1 in total

1.  HPV-Related Neovaginal Squamous Cell Carcinoma Presenting as Lung Metastasis after Male-to-Female Gender Confirmation Surgery.

Authors:  Gang Wang; David Ferguson; Diana N Ionescu; Lien Hoang; Sarah Barrett; Dirk van Niekerk; James Neil Rose; Christian Kollmannsberger
Journal:  Case Rep Oncol       Date:  2020-01-20
  1 in total

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