A Novel Technique of Urethroplasty Could Reduce Urethra-Related Complications in Phalloplasty With Urethral Lengthening
Introduction: Urethral lengthening in phalloplasty could bring many postoperative complications, such as urethra fistula and stricture, which greatly affects the patient's mental health and quality of life. Aim: To describe a novel technique of vaginal mucosal graft for prelamination urethra (V...
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| Format: | Article |
| Language: | English |
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Oxford University Press
2022-12-01
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| Series: | Sexual Medicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2050116122000861 |
| _version_ | 1797709587934085120 |
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| author | Hong Gao, MD Dan Wu, MD Xiangjing Kong, MD Lie Zhu, MD Xiang Jie, MD Wenjun Zhang, MD Zheyuan Hu, MD Xiaohai Zhu, MD |
| author_facet | Hong Gao, MD Dan Wu, MD Xiangjing Kong, MD Lie Zhu, MD Xiang Jie, MD Wenjun Zhang, MD Zheyuan Hu, MD Xiaohai Zhu, MD |
| author_sort | Hong Gao, MD |
| collection | DOAJ |
| description | Introduction: Urethral lengthening in phalloplasty could bring many postoperative complications, such as urethra fistula and stricture, which greatly affects the patient's mental health and quality of life. Aim: To describe a novel technique of vaginal mucosal graft for prelamination urethra (VMGPU) combined with modified urethral anastomosis (MUA) for the reconstruction of a neourethra. Methods: A retrospective study of transgender men between January 2006 and March 2021 was conducted. Patients were divided into three groups according to the surgical methods : traditional group（TG，VMGPU group（VG） and VMGPU+MUA group (VMG). Main Outcome Measure: The main outcomes measures were demographics, surgical characteristics, complications, International Prostate Symptom Score（IPSS，Quality of Life（QOL） score，and voiding frequency conditions. Results: Of 80 eligible transgender men（TG:n = 39，VG:n = 31, VMG:n = 10), the urethral fistula developed in 19/39 (49%) patients in TG, 8/31 (26%) in VG, and 1/10 (10%) in VMG (P = 0.034). The urethral stricture formed in 15/39 (38%) patients in TG, 4/31 (13%) in VG, and 1/10 (10%) in VMG (P = 0.028). Compared with TG, the VG got more favorable IPSS. The QOL scores showed that patients in VG or VMG were more satisfied with their postoperative status. Clinical Implications: VMGPU combined with MUA may help reduce urethral complications for transgender men who wish to undergo phalloplasty with urethral lengthening. Strength & Limitations: VMGPU combined with MUA focuses on reducing the urethra-related complications in the anastomotic stoma between the fixed and the penile urethra, which has not been noticed in the past. The limitations of this study are that the retrospective study design is prone to bias; the study using VMGPU+MUA technique is only in the preliminary stage, and more cases are needed to prove its effectiveness; the median follow-up in VMG was only 2 years, and longer-term follow-up results are inconclusive; the IPSS, QOL, and the voiding frequency chart were not validated in transgender men. Conclusion: Our pilot study suggests that VMGPU combined with MUA may reduce the urethra-related complications, especially the urethral fistula in the anastomosis stoma between the fixed and the penile urethra.Gao H, Wu D, Kong X, et al. A Novel Technique of Urethroplasty Could Reduce Urethra-Related Complications in Phalloplasty With Urethral Lengthening. Sex Med 2022;10:100571. |
| first_indexed | 2024-03-12T06:39:50Z |
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| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-03-12T06:39:50Z |
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| spelling | doaj.art-1b6a2df62be447cebf63f534571ab8372023-09-03T01:05:45ZengOxford University PressSexual Medicine2050-11612022-12-01106100571A Novel Technique of Urethroplasty Could Reduce Urethra-Related Complications in Phalloplasty With Urethral LengtheningHong Gao, MD0Dan Wu, MD1Xiangjing Kong, MD2Lie Zhu, MD3Xiang Jie, MD4Wenjun Zhang, MD5Zheyuan Hu, MD6Xiaohai Zhu, MD7Department of Plastic and Reconstructive Surgery, Second Affiliated Hospital (Chang Zheng Hospital) of Naval Medical University, Huangpu District, Shanghai, China.Department of Plastic and Reconstructive Surgery, Second Affiliated Hospital (Chang Zheng Hospital) of Naval Medical University, Huangpu District, Shanghai, China.Department of Plastic and Reconstructive Surgery, Second Affiliated Hospital (Chang Zheng Hospital) of Naval Medical University, Huangpu District, Shanghai, China.Department of Plastic and Reconstructive Surgery, Second Affiliated Hospital (Chang Zheng Hospital) of Naval Medical University, Huangpu District, Shanghai, China.Department of Plastic and Reconstructive Surgery, Second Affiliated Hospital (Chang Zheng Hospital) of Naval Medical University, Huangpu District, Shanghai, China.Department of Plastic and Reconstructive Surgery, Second Affiliated Hospital (Chang Zheng Hospital) of Naval Medical University, Huangpu District, Shanghai, China.Corresponding Authors: Xiaohai Zhu, MD, Zheyuan Hu, MD, Department of Plastic and Reconstructive Surgery, Second Affiliated Hospital (Chang Zheng Hospital) of Naval Medical University, 415 Fengyang Road, Huangpu District, Shanghai, 200003, China; Department of Plastic and Reconstructive Surgery, Second Affiliated Hospital (Chang Zheng Hospital) of Naval Medical University, Huangpu District, Shanghai, China.Corresponding Authors: Xiaohai Zhu, MD, Zheyuan Hu, MD, Department of Plastic and Reconstructive Surgery, Second Affiliated Hospital (Chang Zheng Hospital) of Naval Medical University, 415 Fengyang Road, Huangpu District, Shanghai, 200003, China; Department of Plastic and Reconstructive Surgery, Second Affiliated Hospital (Chang Zheng Hospital) of Naval Medical University, Huangpu District, Shanghai, China.Introduction: Urethral lengthening in phalloplasty could bring many postoperative complications, such as urethra fistula and stricture, which greatly affects the patient's mental health and quality of life. Aim: To describe a novel technique of vaginal mucosal graft for prelamination urethra (VMGPU) combined with modified urethral anastomosis (MUA) for the reconstruction of a neourethra. Methods: A retrospective study of transgender men between January 2006 and March 2021 was conducted. Patients were divided into three groups according to the surgical methods : traditional group（TG，VMGPU group（VG） and VMGPU+MUA group (VMG). Main Outcome Measure: The main outcomes measures were demographics, surgical characteristics, complications, International Prostate Symptom Score（IPSS，Quality of Life（QOL） score，and voiding frequency conditions. Results: Of 80 eligible transgender men（TG:n = 39，VG:n = 31, VMG:n = 10), the urethral fistula developed in 19/39 (49%) patients in TG, 8/31 (26%) in VG, and 1/10 (10%) in VMG (P = 0.034). The urethral stricture formed in 15/39 (38%) patients in TG, 4/31 (13%) in VG, and 1/10 (10%) in VMG (P = 0.028). Compared with TG, the VG got more favorable IPSS. The QOL scores showed that patients in VG or VMG were more satisfied with their postoperative status. Clinical Implications: VMGPU combined with MUA may help reduce urethral complications for transgender men who wish to undergo phalloplasty with urethral lengthening. Strength & Limitations: VMGPU combined with MUA focuses on reducing the urethra-related complications in the anastomotic stoma between the fixed and the penile urethra, which has not been noticed in the past. The limitations of this study are that the retrospective study design is prone to bias; the study using VMGPU+MUA technique is only in the preliminary stage, and more cases are needed to prove its effectiveness; the median follow-up in VMG was only 2 years, and longer-term follow-up results are inconclusive; the IPSS, QOL, and the voiding frequency chart were not validated in transgender men. Conclusion: Our pilot study suggests that VMGPU combined with MUA may reduce the urethra-related complications, especially the urethral fistula in the anastomosis stoma between the fixed and the penile urethra.Gao H, Wu D, Kong X, et al. A Novel Technique of Urethroplasty Could Reduce Urethra-Related Complications in Phalloplasty With Urethral Lengthening. Sex Med 2022;10:100571.http://www.sciencedirect.com/science/article/pii/S2050116122000861Genital gender affirming surgeryTransgenderPhalloplastyUrethra reconstructionUrethral fistulaUrethral stricture |
| spellingShingle | Hong Gao, MD Dan Wu, MD Xiangjing Kong, MD Lie Zhu, MD Xiang Jie, MD Wenjun Zhang, MD Zheyuan Hu, MD Xiaohai Zhu, MD A Novel Technique of Urethroplasty Could Reduce Urethra-Related Complications in Phalloplasty With Urethral Lengthening Sexual Medicine Genital gender affirming surgery Transgender Phalloplasty Urethra reconstruction Urethral fistula Urethral stricture |
| title | A Novel Technique of Urethroplasty Could Reduce Urethra-Related Complications in Phalloplasty With Urethral Lengthening |
| title_full | A Novel Technique of Urethroplasty Could Reduce Urethra-Related Complications in Phalloplasty With Urethral Lengthening |
| title_fullStr | A Novel Technique of Urethroplasty Could Reduce Urethra-Related Complications in Phalloplasty With Urethral Lengthening |
| title_full_unstemmed | A Novel Technique of Urethroplasty Could Reduce Urethra-Related Complications in Phalloplasty With Urethral Lengthening |
| title_short | A Novel Technique of Urethroplasty Could Reduce Urethra-Related Complications in Phalloplasty With Urethral Lengthening |
| title_sort | novel technique of urethroplasty could reduce urethra related complications in phalloplasty with urethral lengthening |
| topic | Genital gender affirming surgery Transgender Phalloplasty Urethra reconstruction Urethral fistula Urethral stricture |
| url | http://www.sciencedirect.com/science/article/pii/S2050116122000861 |
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