Actas Urologicas Espanolas | 2021
Gender affirmation surgeries in transgender women: Aesthetic, sexual, and urinary results of an initial series of vaginoplasties
Abstract
Abstract Introduction and objectives Gender dysphoria is associated with mental health comorbidity, such as depression and suicide. “Gender affirming surgeries” improve sexuality and psychosocial well-being. The goal of vaginoplasty is for the genitalia to resemble in form and function to a biological vagina with a depth of at least 11\u202fcm and a sensitive clitoris. In addition, the urethra must be shortened and allow voiding in a sitting position. Our objective is to describe the aesthetic, sexual and urinary results. Patients and method Retrospective study of all patients undergoing feminizing genitoplasty, at Hospital Sotero del Rio between 2018 and 2019, that met WPATH requirements. Vaginal dimensions, neo-clitoral sensitivity, aesthetic and sexual satisfaction of the neovagina, questionnaires Female Sexual Function Index (FSFI) and the Female Genital Self-Image Scale (FGSIS), IPSS-QoL, uroflowmetry and post-void residue were evaluated. Results 10 women who underwent feminizing genitoplasty were identified. The neovaginal depth average was 14.2\u202fcm. There was no rectal injury or reoperation. There was 100% of Neoclitoris sensitivity and 88% satisfaction with the neovaginal width. The FGSIS averaged 25.4 points and the FSFI averaged 16 points. The IPSS was 6.7 points, the average Qmax was 22 ml/s and post-void residual volume average was 22\u202fml. There was no neomeatal stenosis. Conclusions Feminizing Genitoplasty is a complex, demanding and not completely standardized surgery. However, it is a relatively safe procedure that achieves adequate aesthetic, sexual and urinary results.