Citation
Blasdel G, Robinson I, Parker A, Zhao LC, Bluebond-Langner R. Familiar Infections in Novel Anatomy: Patient Reports of Sexually Transmitted Infections After Gender Affirming Penile Reconstruction. Sex Transm Dis. 2022 Feb 14. doi: 10.1097/OLQ.0000000000001616. Epub ahead of print. PMID: 35171129.
Abstract
Sexually transmitted infections (STIs) after penile reconstruction in transgender, nonbinary, and other gender expansive (T/GE) populations have not previously been described, despite known risk factors in the population. After T/GE penile reconstruction, care providers may underdiagnose STI without anatomically appropriate guidelines. A detailed anonymous online survey of experiences of T/GE penile reconstruction patients was constructed with community input. Respondents were recruited from online support groups. A total of 128 T/GE people with experience of penile reconstruction responded to an anonymous survey posted in online support groups from January to May 2020. Seven respondents (5.5%) self-reported 1 or more of the listed STIs at any point after penile reconstruction. All respondents with neourethras were diagnosed with localized STIs in nonurethral (extrapenile) locations only, and lack of vaginectomy was correlated with STI (P = 0.002). Sexually transmitted infections were correlated with reporting sex with cisgender men (P = 0.001), transgender men (P = 0.009), and transgender women (P = 0.012). Of health care access variables, only receiving health care at a community health center was correlated with STI history (P = 0.003). This exploratory survey indicates that STI occurs after penile reconstruction in T/GE patients. Clinical confirmation is needed to identify specific risk factors and relative susceptibility of postreconstruction anatomy to STIs. Given no previous surveillance recommendations for this population and the correlation of health care provider location with STI prevalence, underdiagnoses are likely. Based on the authors' clinical experience, we describe a urogenital screening algorithm after gender-affirming penile reconstruction.
Key Points
- Published in Sexually transmitted diseases in 2022.
- Indexed in PubMed as PMID 35171129.
- Mapped to Urethral Stricture & Urethroplasty, Gender-Affirming Surgery, Outcomes, Methods & Education.
- Abstract available from PubMed and rendered as static text on this page.
Clinical Relevance
This publication supports a focused body of work on gender-affirming surgery, including patient-centered outcomes, robotic peritoneal flap vaginoplasty, complications, revisions, and measurement of surgical quality.