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Fifteen-year experience with the Ghent technique of penile inversion vaginoplasty

Dries Opsomer (UGent) , Tom Vyncke (UGent) , Delphine Mertens, Aline Ceulemans (UGent) , Karel Claes (UGent) , Marlon Buncamper (UGent) and Stan Monstrey (UGent)
(2021) PLASTIC AND RECONSTRUCTIVE SURGERY. 148(3). p.416e-424e
Author
Organization
Abstract
Background: Demand for male-to-female gender-affirmation surgery is rising. Creation of a vaginal vault and a feminine vulva remains challenging, especially in circumcised patients. The authors present the 15-year results of the technique developed by the senior author (S.M.). Methods: A retrospective case review was performed of all penile inversion vaginoplasties carried out by the senior author between 2003 and 2017. Age, hormonal therapy time, body mass index, smoking, diabetes, circumcision, and the need for full-thickness skin grafts to lengthen the vaginal vault were investigated as potential risk factors for postoperative complications. Results: A total of 384 penile inversion vaginoplasties were retained, with 85.7 percent of patients requiring a full-thickness skin graft to lengthen the vaginal vault. Rectum perforation occurred in six patients (1.6 percent). Early revisions were necessary in 8.4 percent of patients and late revision surgery was performed in 37.1 percent of cases. There was no independent risk factor for early complications. Diabetes was an independent risk factor for late revision surgery. After vaginoplasty, 97.2 percent of patients reported being able to engage in penetrative intercourse, and 83.4 percent of patients reported having orgasms. Conclusions: Vaginoplasty is possible in all trans women, with most patients being able to engage in penetrative intercourse and reach an orgasm. To reach the desired depth of 14 cm, the neovaginal vault is usually lined with full-thickness skin grafts from the scrotum and/or abdomen. Diabetes was the only independent risk factor for revision surgery. Rectal tears are a rare complication and can usually be managed conservatively. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
Keywords
Surgery, MALE-TRANSSEXUALS, SURGERY, FLAP

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MLA
Opsomer, Dries, et al. “Fifteen-Year Experience with the Ghent Technique of Penile Inversion Vaginoplasty.” PLASTIC AND RECONSTRUCTIVE SURGERY, vol. 148, no. 3, 2021, pp. 416e–24e, doi:10.1097/prs.0000000000008300.
APA
Opsomer, D., Vyncke, T., Mertens, D., Ceulemans, A., Claes, K., Buncamper, M., & Monstrey, S. (2021). Fifteen-year experience with the Ghent technique of penile inversion vaginoplasty. PLASTIC AND RECONSTRUCTIVE SURGERY, 148(3), 416e–424e. https://doi.org/10.1097/prs.0000000000008300
Chicago author-date
Opsomer, Dries, Tom Vyncke, Delphine Mertens, Aline Ceulemans, Karel Claes, Marlon Buncamper, and Stan Monstrey. 2021. “Fifteen-Year Experience with the Ghent Technique of Penile Inversion Vaginoplasty.” PLASTIC AND RECONSTRUCTIVE SURGERY 148 (3): 416e–24. https://doi.org/10.1097/prs.0000000000008300.
Chicago author-date (all authors)
Opsomer, Dries, Tom Vyncke, Delphine Mertens, Aline Ceulemans, Karel Claes, Marlon Buncamper, and Stan Monstrey. 2021. “Fifteen-Year Experience with the Ghent Technique of Penile Inversion Vaginoplasty.” PLASTIC AND RECONSTRUCTIVE SURGERY 148 (3): 416e–424e. doi:10.1097/prs.0000000000008300.
Vancouver
1.
Opsomer D, Vyncke T, Mertens D, Ceulemans A, Claes K, Buncamper M, et al. Fifteen-year experience with the Ghent technique of penile inversion vaginoplasty. PLASTIC AND RECONSTRUCTIVE SURGERY. 2021;148(3):416e–24e.
IEEE
[1]
D. Opsomer et al., “Fifteen-year experience with the Ghent technique of penile inversion vaginoplasty,” PLASTIC AND RECONSTRUCTIVE SURGERY, vol. 148, no. 3, pp. 416e–424e, 2021.
@article{8736664,
  abstract     = {{Background: Demand for male-to-female gender-affirmation surgery is rising. Creation of a vaginal vault and a feminine vulva remains challenging, especially in circumcised patients. The authors present the 15-year results of the technique developed by the senior author (S.M.). 

Methods: A retrospective case review was performed of all penile inversion vaginoplasties carried out by the senior author between 2003 and 2017. Age, hormonal therapy time, body mass index, smoking, diabetes, circumcision, and the need for full-thickness skin grafts to lengthen the vaginal vault were investigated as potential risk factors for postoperative complications. 

Results: A total of 384 penile inversion vaginoplasties were retained, with 85.7 percent of patients requiring a full-thickness skin graft to lengthen the vaginal vault. Rectum perforation occurred in six patients (1.6 percent). Early revisions were necessary in 8.4 percent of patients and late revision surgery was performed in 37.1 percent of cases. There was no independent risk factor for early complications. Diabetes was an independent risk factor for late revision surgery. After vaginoplasty, 97.2 percent of patients reported being able to engage in penetrative intercourse, and 83.4 percent of patients reported having orgasms. 

Conclusions: Vaginoplasty is possible in all trans women, with most patients being able to engage in penetrative intercourse and reach an orgasm. To reach the desired depth of 14 cm, the neovaginal vault is usually lined with full-thickness skin grafts from the scrotum and/or abdomen. Diabetes was the only independent risk factor for revision surgery. Rectal tears are a rare complication and can usually be managed conservatively. 

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.}},
  author       = {{Opsomer, Dries and Vyncke, Tom and Mertens, Delphine and Ceulemans, Aline and Claes, Karel and Buncamper, Marlon and Monstrey, Stan}},
  issn         = {{0032-1052}},
  journal      = {{PLASTIC AND RECONSTRUCTIVE SURGERY}},
  keywords     = {{Surgery,MALE-TRANSSEXUALS,SURGERY,FLAP}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{416e--424e}},
  title        = {{Fifteen-year experience with the Ghent technique of penile inversion vaginoplasty}},
  url          = {{http://dx.doi.org/10.1097/prs.0000000000008300}},
  volume       = {{148}},
  year         = {{2021}},
}

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