Penile-scrotal flap vaginoplasty versus inverted penile skin flap expanded with spatulated urethra: A multidisciplinary single-centre analysis

  • Giorgio Gentile Andrology Unit, University Hospital S.Orsola-Malpighi, Bologna, Italy.
  • Ardigò Martino Institute for Integrated Health, Federal University of Mato Grosso Do Sul, Campo Grande MS, Brazil.
  • Daniela Nadalin Health Centre Gender Dysphoria at Movement for Transsexual Identity – Agreement with Local Health care Unit, City of Bologna, Italy.
  • Martina Masetti Department of Urology, University of Bologna, Italy.
  • Brigida Lilia Marta Department of Anthropology, Medical Anthropology Research Center, Rovira I Virgili University, Tarragona, Spain.
  • Franco Palmisano | franco.palmisano@hotmail.it Andrology Unit, University Hospital S.Orsola-Malpighi, Bologna, Italy. http://orcid.org/0000-0002-0197-9033
  • Alessandro Franceschelli Andrology Unit, University Hospital S.Orsola-Malpighi, Bologna, Italy.
  • Patrizia Stella Health Centre Gender Dysphoria at Movement for Transsexual Identity – Agreement with Local Health care Unit, City of Bologna, Italy.
  • Anna Paola Sanfelici Health Centre Gender Dysphoria at Movement for Transsexual Identity – Agreement with Local Health care Unit, City of Bologna, Italy.
  • Eugenio Brunocilla Department of Urology, University of Bologna, Italy.
  • Fulvio Colombo Andrology Unit, University Hospital S.Orsola-Malpighi, Bologna, Italy.

Abstract

This study is aimed to compare outcomes of penile-scrotal flap vaginoplasty to inverted penile skin flap expanded with spatulated urethra as a singlecentre experience. Data regarding vaginoplasty performed between May 2003 and January 2014 were reviewed. Subjects were divided into two groups according to the surgical technique performed: perineal- scrotal flap vaginoplasty (Group A), and inverted penile skin flap expanded with spatulated urethra vaginoplasty (Group B). All patients underwent to psychological analysis before surgery. Functional follow-up was based on a modified validated Female Sexual Function Index. Overall, 67 patients with a mean (SD) age of 34 (±9.38) years underwent to surgery. 41 patients were included into the Group A and 26 into the Group B. Mean operative time among Groups A and B was 316 (±101.65) and 594 (±89.06) minutes, respectively (p<0.0001). Longer postoperative hospitalization was shown in Group B (14 days ± 4,51) than in Group A (10 days ± 2,49); (p<0.0001). Group B patients showed a higher anemization rate requiring blood transfusion (p=0.00014) as well as compressive neuropathy (p=0.038). In addition to this, necrosis of the skin flap was reported in 8 patients of Group B (p<0.0001). Comprehensive functional follow-up data was included; spontaneous vaginal lubrication was not reported in 82.4% of Group A vs 12.5% cases of Group B (p=0.0085). When compared to penile-scrotal flap vaginoplasty, inverted penile skin flap expanded with spatulated urethra technique shows an increased risk of complications with comparable satisfaction rates whereas a higher spontaneous vaginal lubrication is reported. Sexological support is of utmost importance in this setting.

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Published
2020-10-01
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Section
Original Papers - Andrology
Keywords:
Transgender; Penile inversion; Vaginoplasty; Techniques; Outcomes, Sexologist
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How to Cite
Gentile, G., Martino, A., Nadalin, D., Masetti, M., Marta, B. L., Palmisano, F., Franceschelli, A., Stella, P., Sanfelici, A. P., Brunocilla, E., & Colombo, F. (2020). Penile-scrotal flap vaginoplasty versus inverted penile skin flap expanded with spatulated urethra: A multidisciplinary single-centre analysis. Archivio Italiano Di Urologia E Andrologia, 92(3). https://doi.org/10.4081/aiua.2020.3.186

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