Outcomes of transperineal gender-affirming vaginectomy and colpocleisis

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: There are multiple approaches to vaginectomy for the purpose of masculinizing gender-affirming genital surgery including mucosal fulguration and excision. The outcomes of the approaches are not well described. We aim to describe the surgical outcomes of gender-affirming vaginectomy and colpocleisis by complete mucosal excision. Methods: We performed a case series study of 40 transmasculine patients who underwent gender-affirming vaginectomy and colpocleisis. Vaginectomy was performed by complete excision of the vaginal mucosa via a transperineal approach. We recorded perioperative outcomes and operative time. We performed a multivariate analysis to assess patient factors on operative outcomes. Results: Forty vaginectomies were performed between September 2016 and April 2019, 27 (67.5%) in phalloplasty patients and 13 (32.5%) in metoidioplasty patients. Perioperative complications included 2 blood transfusions, 1 pelvic hematoma, and 1 Clostridium cifficile colitis. No urethral fistulae to the vaginal space, mucoceles, or visceral injures were seen with a median follow-up of 7.7 months. Operative time decreased significantly with later surgery year. Conclusions: This is a large series studying the outcomes of gender-affirming vaginectomy by complete mucosal excision approach in the literature. Perioperative complications were low. Operative time decreased overtime such that after approximately 20 cases, the procedure fairly consistently takes 2 to 2.5 hours to perform.

Original languageEnglish (US)
Pages (from-to)300-303
Number of pages4
JournalFemale Pelvic Medicine and Reconstructive Surgery
Volume27
Issue number5
DOIs
StatePublished - 2021

Keywords

  • Colpocleisis
  • Female-to-male
  • Gender-affirming genital surgery
  • Transgender
  • Vaginectomy

ASJC Scopus subject areas

  • Surgery
  • Obstetrics and Gynecology
  • Urology

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