Citation
Robinson IS, Cripps CN, Bluebond-Langner R, Zhao LC. Operative Management of Complications Following Intestinal Vaginoplasty: A Case Series and Systematic Review. Urology. 2023 Jul 20:S0090-4295(23)00592-7. doi: 10.1016/j.urology.2023.07.005. Epub ahead of print. PMID: 37479146.
Abstract
To describe the authors' experience with surgical management of complications following intestinal vaginoplasty and review the literature on incidence of complications following gender-affirming intestinal vaginoplasty. Retrospective chart review identified patients presenting with complications following prior intestinal vaginoplasty requiring operative management. Charts were analyzed for medical history, preoperative exam and imaging, intraoperative technique, and long-term outcomes. Systematic literature review was performed to identify primary research on complications following gender-affirming intestinal vaginoplasty. Four patients presented to the senior authors' clinic requiring operative intervention for complications following intestinal vaginoplasty, all of whom underwent surgical revision. Complications included vaginal stenosis (2 patients, 50%), vaginal false passage (1 patient, 25%), and diversion colitis (1 patient, 25%). Postoperatively all patients were able to dilate successfully to a depth of at least 15 cm. Systematic review identified 10 studies meeting inclusion criteria. There were 215 complications reported across 654 vaginoplasties (33% overall complication rate). Average return to operating room rate was 18%. The most common complications were stenosis (11%), mucorrhea (7%), vaginal prolapse (6%), and malodor (5%). Six intestinal vaginoplasty segments developed vascular compromise leading to flap loss. There were 2 reported mortalities. Intestinal vaginoplasty is associated with a range of complications including vaginal stenosis, mucorrhea, and vaginal prolapse. Intra-abdominal complications, including diversion colitis, anastomotic bowel leak, and intra-abdominal abscess can occur many years after surgery, be life-threatening and require prompt diagnosis and management.
Key Points
- Published in Urology in 2023.
- Indexed in PubMed as PMID 37479146.
- Mapped to 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.