Affiliation:
1. I.M. Sechenov First Moscow State Medical University (Sechenov University)
Abstract
Purpose of the study: a comparison of various vaginoplasty techniques and results in patients with transsexualism based on the analysis of data from the world scientific literature.Material and methods. The seeking of published research results placed in open databases by keywords. A total of 391 articles were initially analyzed of which 33 have met our acceptability criteria. A total of 3716 cases were analyzed where patients have undergone penile inversion, flap surgery (scrotal flap, free flap, rotational flap), endoscopic method and other modifications of vaginoplasty. The method includes comparing of the presented surgery techniques, their functional and aesthetic results, and complications rate.Results. Due to the involvement of different criteria for the results of surgical treatment evaluation by different scientific teams, as well as the insufficient number of objective studies on some methods, it is difficult to match the methods, their outcome, and complications. However, based on the described experience of practitioners and researchers, it can be concluded that the penile inversion technique is the most examined one and has a stable and appropriate results. Laparoscopic methods are equally effective but have a few specificities. The scrotal flap seems to be the most promising method that meets all the criteria for vaginoplasty in transsexuals. Free flaps or the rotational flaps usage has historical importance and could be used in certain circumstances.Conclusion. Various surgical techniques have demonstrated the safety and reliability of vaginoplasty in MtoF patients providing the low number of complications and a significant improvement in the patient's quality of life. Studies using different methods in a similar population and standardized results obtained from patients are required to further analyze the results of various methods to highlight the main principles for use in practice.
Publisher
Research Institute of Microsurgery
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