Muhammed Al-Tamimi1, Garry L Pigot2, Wouter B van der Sluis3, Tim C van de Grift4, Margriet G Mullender4, Freek Groenman5, Mark-Bram Bouman6. 1. Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands; Department of Urology, VU University Medical Center, Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands. 2. Department of Urology, VU University Medical Center, Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands. 3. Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands. 4. Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands; Centre of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands. 5. Department of Gynecology, VU University Medical Center, Amsterdam, The Netherlands. 6. Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands; Centre of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, The Netherlands; Gender Surgery Amsterdam, Amsterdam, The Netherlands. Electronic address: Mark-Bram.Bouman@vumc.nl.
Abstract
PURPOSE: We assessed the effect of performing colpectomy before (primary) or after (secondary) gender affirming surgery with single stage urethral lengthening on the incidence of urethral fistula in transgender men. MATERIALS AND METHODS: We retrospectively reviewed the charts of all transgender men who underwent gender affirming surgery with urethral lengthening between January 1989 and November 2016 at VU University Medical Center. Patient demographics, surgical characteristics, fistulas and fistula management, and primary and secondary colpectomy were recorded. Descriptive statistics were calculated and incidence rates were compared. RESULTS: A total of 294 transgender men underwent gender affirming surgery with urethral lengthening. A urethral fistula developed in 111 of the 232 patients (48%) without colpectomy and in 13 of the 62 (21%) who underwent primary colpectomy (p <0.01). Secondary colpectomy resulted in 100% fistula closure when performed in 17 patients with recurrent urethral fistula at the proximal urethral anastomosis and the fixed part of the neourethra. CONCLUSIONS: Primary colpectomy decreases the incidence rate of urethral fistulas. Secondary colpectomy is also an effective treatment of fistulas at the proximal urethral anastomosis and the fixed part of the neourethra.
PURPOSE: We assessed the effect of performing colpectomy before (primary) or after (secondary) gender affirming surgery with single stage urethral lengthening on the incidence of urethral fistula in transgender men. MATERIALS AND METHODS: We retrospectively reviewed the charts of all transgender men who underwent gender affirming surgery with urethral lengthening between January 1989 and November 2016 at VU University Medical Center. Patient demographics, surgical characteristics, fistulas and fistula management, and primary and secondary colpectomy were recorded. Descriptive statistics were calculated and incidence rates were compared. RESULTS: A total of 294 transgender men underwent gender affirming surgery with urethral lengthening. A urethral fistula developed in 111 of the 232 patients (48%) without colpectomy and in 13 of the 62 (21%) who underwent primary colpectomy (p <0.01). Secondary colpectomy resulted in 100% fistula closure when performed in 17 patients with recurrent urethral fistula at the proximal urethral anastomosis and the fixed part of the neourethra. CONCLUSIONS: Primary colpectomy decreases the incidence rate of urethral fistulas. Secondary colpectomy is also an effective treatment of fistulas at the proximal urethral anastomosis and the fixed part of the neourethra.
Authors: Müjde Özer; Sahaand Poor Toulabi; Alessandra D Fisher; Guy T'Sjoen; Marlon E Buncamper; Stan Monstrey; Marta R Bizic; Miroslav Djordjevic; Marco Falcone; Nim A Christopher; Daniel Simon; Luis Capitán; Joz Motmans Journal: Sex Med Date: 2021-12-28 Impact factor: 2.491
Authors: Freek P W de Rooij; Femke R M Peters; Brechje L Ronkes; Wouter B van der Sluis; Muhammed Al-Tamimi; R Jeroen A van Moorselaar; Mark-Bram Bouman; Garry L S Pigot Journal: BJU Int Date: 2021-06-17 Impact factor: 5.969