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Inicio Actas Urológicas Españolas (English Edition) Gender affirmation surgeries in transgender women: Aesthetic, sexual, and urinar...
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Vol. 45. Issue 3.
Pages 225-231 (April 2021)
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Vol. 45. Issue 3.
Pages 225-231 (April 2021)
Original article
Gender affirmation surgeries in transgender women: Aesthetic, sexual, and urinary results of an initial series of vaginoplasties
Cirugías de afirmación de género en mujeres trans: resultados estéticos, sexuales y urinarios de una serie inicial de vaginoplastias
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J. Bernal Riquelmea,b, N. Falcon Naserc, J. Barros Puertasa, J. Arenas Kalila,d, M. Cifuentes Arévaloa,e,
Corresponding author
melissacifuentesa@gmail.com

Corresponding author.
a Servicio de Urología, Hospital Sotero del Río, Santiago de Chile, Chile
b Clínica Indisa, Santiago de Chile, Chile
c Servicio de Urología, Hospital San José de Maipo, Santiago de Chile, Chile
d Universidad Católica de Chile, Santiago de Chile, Chile
e Hospital Carlos Van Buren, Universidad de Valparaiso, Valparaíso, Chile
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Figures (2)
Tables (5)
Table 1. General characteristics of the study group.
Table 2. Neovaginal size at the end of surgery and at completion of follow-up.
Table 3. Results to original questions assessing sensitivity, sexual function and perceived impact on quality of life. FGSIS and FSFI results.
Table 4. Female Genital Self-Image Scale (FGSIS). Detail of mean score per question.
Table 5. Results of the urinary function assessment.
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Abstract
Introduction and objectives

Gender dysphoria is associated with mental health comorbidity, such as depression and suicide. “Gender affirming surgeries” improve sexuality and psychosocial well-being. The goal of vaginoplasty is for the genitalia to resemble in form and function to a biological vagina with a depth of at least 11 cm and a sensitive clitoris. In addition, the urethra must be shortened and allow voiding in a sitting position. Our objective is to describe the aesthetic, sexual and urinary results.

Patients and method

Retrospective study of all patients undergoing feminizing genitoplasty, at Hospital Sótero del Río between 2018 and 2019, that met WPATH requirements. Vaginal dimensions, neo-clitoral sensitivity, aesthetic and sexual satisfaction of the neovagina, questionnaires Female Sexual Function Index (FSFI) and the Female Genital Self-Image Scale (FGSIS), IPSS-QoL, uroflowmetry and post-void residue were evaluated.

Results

10 women who underwent feminizing genitoplasty were identified. The neovaginal depth average was 14.2 cm. There was no rectal injury or reoperation. There was 100% of Neoclitoris sensitivity and 88% satisfaction with the neovaginal width.

The FGSIS averaged 25.4 points and the FSFI averaged 16 points. The IPSS was 6.7 points, the average Qmax was 22 ml/s and post-void residual volume average was 22 ml. There was no neomeatal stenosis.

Conclusions

Feminizing Genitoplasty is a complex, demanding and not completely standardized surgery. However, it is a relatively safe procedure that achieves adequate aesthetic, sexual and urinary results.

Keywords:
Transsexual
Transgender
Gender dysphoria
Reconstruction genital reassignment
Vaginoplasty
Resumen
Introducción y objetivos

La disforia de género se asocia a elevada comorbilidad de salud mental, como depresión y suicidio. Las «cirugías de afirmación de género» mejoran la sexualidad y el bienestar psicosocial. El objetivo de la vaginoplastia es que los genitales se asemejen en forma y función a una vagina con una profundidad de al menos 11 cm y un clítoris sensible. Además, la uretra debe acortarse y permitir la micción en posición sentada. Nuestro objetivo es describir los resultados estéticos, sexuales y urinarios.

Pacientes y método

Estudio retrospectivo de todas las pacientes operadas de genitoplastia feminizante en el Hospital Sótero del Río entre 2018 y 2019 que cumplían requisitos de WPATH. Se evaluaron dimensiones vaginales, sensibilidad del neoclítoris, conformidad estética y sexual de la neovagina, cuestionarios Índice de Función Sexual Femenina (FSFI) y la Escala de Autoimagen Genital Femenina (FGSIS), IPSS-QoL, uroflujometría y residuo posmiccional.

Resultados

Se identificaron 10 mujeres operadas de genioplastia feminizante. La profundidad promedio neovaginal fue de 14,2 cm. No hubo lesión rectal ni reoperación. Hubo 100% de sensibilidad del neoclítoris y 88% de conformidad con el ancho neovaginal. La FGSIS promedió 25,4 puntos y el FSFI promedió 16 puntos. El IPSS fue de 6,7 puntos, el Qmax promedio fue de 22 ml/s y el residuo posmiccional promedio fue de 22 ml. No hubo estenosis del neomeato.

Conclusiones

La genitoplastia feminizante es una cirugía compleja, exigente y no completamente estandarizada. Sin embargo, es un procedimiento relativamente seguro que logra adecuados resultados estéticos, sexuales y urinarios.

Palabras clave:
Transexual
Transgénero
Disforia de género
Reconstrucción reasignación genital
Vaginoplastía

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