SURGICAL OUTCOMES of URETHRAL LENGTHENING in the CONTEXT of GENITAL GENDER-CONFIRMING SURGERY in TRANSGENDER MEN in Journal of Sexual Medicine
2023
AOU Città della Salute di Torino
Tipo pubblicazione
Conference Abstract
Autori/Collaboratori (8)Vedi tutti...
Falcone M
Città della Salute e della Scienza di Torino, Deparment of Urology, Turin, Italy
Preto M
Città della Salute e della Scienza di Torino, Deparment of Urology, Turin, Italy
Ferro I
Città della Salute e della Scienza di Torino, Deparment of Urology, Turin, Italy
et alii...
Abstract
Objectives: Our study aim is to analyze the surgical and functional outcomes after urethral reconstruction in consecutive series of transgender men who underwent genital gender-confirming surgery. MethodsA retrospective monocentric cohort study was conducted. From 2015 to 2022, patients who underwent urethral lengthening in the context of GGCS were enrolled. Surgical outcomes and postoperative complications were reported. Three questionnaires were administered to evaluate patients' urinary function (CCO-EPIC, ICIQ-SF) and patients' psychological well-being (BDI-scale of depression). A 6-item ad hoc created questionnaire was administered to inquire patients' reported outcomes. Results: 31 patients were included in the study. 11 underwent metoidioplasty (Group A), while 20 underwent phalloplasty with different techniques (Group B). The descriptive characteristics between the two groups were comparable, except for the BMI resulting greater in Group B (p-value 0.012). Average follow-up was 18 months (±18SD). Mean operative time was 160 minutes (±43 SD). No significant intraoperative complications occurred. Early postoperative complication rate resulted significantly higher for group B (83.3% p-value 0.034). The most frequent complication, urethral fistula, healed in all cases after prolonged catheterization. Overall 9.6% of patients needed a surgical revision to address urethral complications. CCO-EPIC and ICIQ-SF administered preoperatively and 1-year after surgery showed worsening in urinary function (p-value = 0.04 and p-value = 0.02 respectively), BDI score showed a significant improvement in postoperative settings (p-value= 0.02). 82 % of the patients after 1-year follow-up were satisfied with the procedure and 81 % declared that surgery had a positive impact on their quality of life. The main limitations of the study are the limited follow-up, the non-randomized nature of the study and the small number of patients. Conclusions: Urethral reconstruction in
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DOI : 10.1093/jsxmed/qdad062.085
Keywords
adult; body mass; catheterization; clinical article; clinical evaluation; cohort analysis; complication; conference abstract; controlled study; depression; female; follow up; gender affirming surgery; human; incidence; International Consultation on Incontinence Questionnaire; male; metoidioplasty; operation duration; outcome assessment; peroperative complication; phalloplasty; postoperative complication; preoperative evaluation; psychological well-being; quality of life; reconstructive surgery; retrospective study; surgery; transgender; urethra fistula;