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Cytology of the 'penile' neovagina in transsexual women

Steven Weyers (UGent) , Kathleen Lambein (UGent) , Yvonne Sturtewagen, Hans Verstraelen (UGent) , Jan Gerris (UGent) and Marleen Praet (UGent)
(2010) CYTOPATHOLOGY. 21(2). p.111-115
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Abstract
Objective: The primary objective was to describe the neovaginal cytology in transsexual patients (n = 50) treated with the inverted penile skin technique. Secondary objectives were to compare our cytological findings with patient characteristics including use of oestrogens, sexual orientation and penetrative intercourse. Methods: The medical and surgical history, sexual orientation and whether there was a current relationship were ascertained. A speculum examination was followed by microscopy of a Pap smear of the neovaginal vault. Results: Well-preserved nucleated squamous cells were found in 72%. The correlation between their presence and sexual orientation was highly significant (P = 0.016), with those not sexually interested and homosexually oriented all having nucleated cells on the Pap smear. However, the correlation between these cells and penetrative intercourse failed to reach significance. Four samples showed atypical squamous cells of undetermined significance, all were negative for high-risk human papillomavirus (HR-HPV) types. One patient showed a low-grade squamous intraepithelial lesion that was HR-HPV positive. There was a significant correlation between the presence of cytological lesions and sexual orientation (P = 0.006). Four percentage of the specimens showed Doderlein bacilli. Inflammation was found in 30.6% of samples with squamous cells. Conclusions: The penile skin-lined neovagina of transsexual women can reflect the cytological findings present in biological women. However 'normal' cervical cytology, with superficial, intermediate and parabasal cells as well as Doderlein bacilli, was found in only 4% of transsexual women. Although one patient's Pap test showed koilocytes and was HR-HPV positive, no high-grade squamous intraepithelial lesions were identified.
Keywords
gender identity, cytology, transsexualism, vaginal smears, neovagina, BACTERIAL VAGINOSIS, GONOCOCCAL-INFECTION, CERVICAL CYTOLOGY, SKIN

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Please use this url to cite or link to this publication:

Chicago
Weyers, Steven, Kathleen Lambein, Yvonne Sturtewagen, Hans Verstraelen, Jan Gerris, and Marleen Praet. 2010. “Cytology of the ‘Penile’ Neovagina in Transsexual Women.” Cytopathology 21 (2): 111–115.
APA
Weyers, S., Lambein, K., Sturtewagen, Y., Verstraelen, H., Gerris, J., & Praet, M. (2010). Cytology of the “penile” neovagina in transsexual women. CYTOPATHOLOGY, 21(2), 111–115.
Vancouver
1.
Weyers S, Lambein K, Sturtewagen Y, Verstraelen H, Gerris J, Praet M. Cytology of the “penile” neovagina in transsexual women. CYTOPATHOLOGY. 2010;21(2):111–5.
MLA
Weyers, Steven, Kathleen Lambein, Yvonne Sturtewagen, et al. “Cytology of the ‘Penile’ Neovagina in Transsexual Women.” CYTOPATHOLOGY 21.2 (2010): 111–115. Print.
@article{875252,
  abstract     = {Objective: The primary objective was to describe the neovaginal cytology in transsexual patients (n = 50) treated with the inverted penile skin technique. Secondary objectives were to compare our cytological findings with patient characteristics including use of oestrogens, sexual orientation and penetrative intercourse.
Methods: The medical and surgical history, sexual orientation and whether there was a current relationship were ascertained. A speculum examination was followed by microscopy of a Pap smear of the neovaginal vault.
Results: Well-preserved nucleated squamous cells were found in 72\%. The correlation between their presence and sexual orientation was highly significant (P = 0.016), with those not sexually interested and homosexually oriented all having nucleated cells on the Pap smear. However, the correlation between these cells and penetrative intercourse failed to reach significance. Four samples showed atypical squamous cells of undetermined significance, all were negative for high-risk human papillomavirus (HR-HPV) types. One patient showed a low-grade squamous intraepithelial lesion that was HR-HPV positive. There was a significant correlation between the presence of cytological lesions and sexual orientation (P = 0.006). Four percentage of the specimens showed Doderlein bacilli. Inflammation was found in 30.6\% of samples with squamous cells.
Conclusions: The penile skin-lined neovagina of transsexual women can reflect the cytological findings present in biological women. However 'normal' cervical cytology, with superficial, intermediate and parabasal cells as well as Doderlein bacilli, was found in only 4\% of transsexual women. Although one patient's Pap test showed koilocytes and was HR-HPV positive, no high-grade squamous intraepithelial lesions were identified.},
  author       = {Weyers, Steven and Lambein, Kathleen and Sturtewagen, Yvonne and Verstraelen, Hans and Gerris, Jan and Praet, Marleen},
  issn         = {0956-5507},
  journal      = {CYTOPATHOLOGY},
  keyword      = {gender identity,cytology,transsexualism,vaginal smears,neovagina,BACTERIAL VAGINOSIS,GONOCOCCAL-INFECTION,CERVICAL CYTOLOGY,SKIN},
  language     = {eng},
  number       = {2},
  pages        = {111--115},
  title        = {Cytology of the 'penile' neovagina in transsexual women},
  url          = {http://dx.doi.org/10.1111/j.1365-2303.2009.00663.x},
  volume       = {21},
  year         = {2010},
}

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