Patient reported symptoms and adverse outcomes seen in Canada's first vaginoplasty postoperative care clinic

Author:

Potter Emery12,Sivagurunathan Marudan1,Armstrong Kathleen1,Barker Lucy C13,Du Mont Janice14,Lorello Gianni R.1567,Millman Alexandra18ORCID,Urbach David R.189,Krakowsky Yonah1810

Affiliation:

1. Women's College Research Institute Women's College Hospital Toronto Ontario Canada

2. Lawrence S. Bloomberg Faculty of Nursing University of Toronto Toronto Ontario Canada

3. Department of Psychiatry University of Toronto Toronto Ontario Canada

4. Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada

5. Department of Anesthesiology and Pain Medicine University of Toronto Toronto Ontario Canada

6. Department of Anesthesia and Pain Management University Health Network ‐ Toronto Western Hospital Toronto Ontario Canada

7. The Wilson Centre University Health Network Toronto Ontario Canada

8. Transition Related Surgery Program, Women's College Hospital University of Toronto Toronto Ontario Canada

9. Department of Surgery Women's College Hospital Toronto Ontario Canada

10. Division of Urology, Department of Surgery University of Toronto Toronto Ontario Canada

Abstract

AbstractImportanceVaginoplasty is a relatively common gender‐affirming surgery with approximately 200 Ontarians seeking this surgery annually. Although Ontario now offers vaginoplasty in province, the capacity is not meeting demand; the majority of trans and gender‐diverse patients continue to seek vaginoplasty out of province. Out‐of‐province surgery presents a barrier to accessing postsurgical follow‐up care leaving most patients to seek support from their primary care providers or providers with little experience in gender‐affirming surgery.ObjectiveTo provide an account of the common postoperative care needs and neovaginal concerns of Ontarians who underwent penile inversion vaginoplasty out of province and presented for care at a gender‐affirming surgery postoperative care clinic.Design, Settings, and ParticipantsA retrospective chart review of the first 80 patients presenting to a gender‐affirming surgery postoperative care clinic who had undergone vaginoplasty at an outside surgical center was performed. Descriptive analyses were performed for all variables.ResultsThe sample consisted of 80 individuals with the mean age of 39 years (19–73). Most patients had surgery at another surgical center in Canada (76.3%). Many patients (22.5%) accessed care in the first 3 months after surgery, with the majority (55%) seeking care within the first perioperative year. Most patients (61.3%) were seen for more than one visit and presented with more than two symptoms or concerns.Common patient‐reported symptoms during clinical visit included pain (53.8%), dilation concerns (46.3%), and surgical site/vaginal bleeding (42.5%). Sexual function concerns were also common (33.8%) with anorgasmia (11.3%) and dyspareunia (11.3%) being the most frequent complications. The most common adverse outcomes identified by health care providers included hypergranulation (38.8%), urinary dysfunction (18.8%), and wound healing issues (12.5%).Conclusions and RelevanceFindings from chart review offer valuable insights into the postoperative needs and neovaginal concerns of Ontarians who have had vaginoplasty out of province. This study demonstrates the need for routine postoperative care in patients undergoing vaginoplasty. Patients experience numerous symptoms and concerns that often correlate with clinical findings and require multiple follow‐up appointments. Health care providers may benefit from further education on the more common nonsurgical issues identified in this study.

Publisher

Wiley

Subject

Urology,Neurology (clinical)

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