The following is a summary of “Operative Management of Complications Following Intestinal Vaginoplasty: A Case Series and Systematic Review,” published in the October 2023 issue of Urology by Robinson et al.
The purpose of this study was to share experience in surgically managing complications arising from intestinal vaginoplasty and to conduct a literature review on the incidence of complications following gender-affirming intestinal vaginoplasty.
A retrospective analysis of patient charts was conducted to identify individuals with complications from previous intestinal vaginoplasty that necessitated operative intervention. The charts were carefully examined for medical history, preoperative examinations and imaging, intraoperative techniques, and long-term outcomes. Additionally, a systematic review of the literature was undertaken to identify primary research on complications associated with gender-affirming intestinal vaginoplasty.
About 4 patients required surgical intervention for complications arising from intestinal vaginoplasty, and all underwent surgical revision. The complications included vaginal stenosis (2 patients, 50%), vaginal false passage (1 patient, 25%), and diversion colitis (1 patient, 25%). Following the surgeries, all patients could dilate to a depth of at least 15 cm.
The systematic review identified 10 studies meeting the inclusion criteria, reporting 215 complications in 654 vaginoplasties (33% overall complication rate). The average return to the operating room rate was 18%. The most common complications included stenosis (11%), mucorrhea (7%), vaginal prolapse (6%), and malodor (5%). Six intestinal vaginoplasty segments experienced vascular compromise, leading to flap loss. Additionally, two reported mortalities were documented.
Intestinal vaginoplasty is associated with various complications such as vaginal stenosis, mucorrhea, and vaginal prolapse. Moreover, intra-abdominal complications, including diversion colitis, anastomotic bowel leak, and intra-abdominal abscess, can manifest many years post-surgery, posing life-threatening risks that necessitate prompt diagnosis and management.
Source: goldjournal.net/article/S0090-4295(23)00592-7/fulltext
