Ileal vaginoplasty as vaginal reconstruction in transgender women and patients with disorders of sex development: an international, multicentre, retrospective study on surgical characteristics and outcomes

Wouter B. van der Sluis, Nicola Pavan, Giovanni Liguori, Stefano Bucci, Marta R. Bizic, Vladimir Kojovic, Jochen Hess, Wilhelmus J.H.J. Meijerink, Margriet G. Mullender, Müjde Özer, Jan Maerten Smit, Marlon E. Buncamper, Susanne Krege, Miroslav L. Djordjevic, Carlo Trombetta, Mark Bram Bouman

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objective: To describe the surgical outcomes of ileal vaginoplasty in transgender women and patients with disorders of sex development (DSD). Patients and Methods: Transgender women and patients with DSD, who underwent ileal vaginoplasty at the VU University Medical Center Amsterdam, University Hospital Trieste, University Hospital Essen, and Belgrade University Hospital, were retrospectively identified. A chart review was performed, recording surgical technique, intraoperative characteristics, complications, and re-operations. Results: We identified a total of 32 patients (27 transgender and five non-transgender), with a median (range) age of 35 (6–63) years. Ileal vaginoplasty was performed as the primary procedure in three and as a revision procedure in the remaining 29. The mean (sd) operative time was 288 (103) min. The procedure was performed laparoscopically (seven patients) or open (25). An ileal ‘U-pouch’ was created in five patients and a single lumen in 27. Intraoperative complications occurred in two patients (one iatrogenic bladder damage and one intraoperative blood loss necessitating transfusion). The median (range) hospitalisation was 12 (6–30) days. Successful neovaginal reconstruction was achieved in all. The mean (sd) achieved neovaginal depth was 13.2 (3.1) cm. The median (range) clinical follow-up was 35 (3–159) months. In one patient a recto-neovaginal fistula occurred, which lead to temporary ileostomy. Introital stenosis occurred in four patients (12.5%). Conclusion: Ileal vaginoplasty can be performed with few intra- and postoperative complications. It appears to have similar complication rates when compared to sigmoid vaginoplasty. It now seems to be used predominantly for revision procedures.

Original languageEnglish
Pages (from-to)952-958
Number of pages7
JournalBJU International
Volume121
Issue number6
DOIs
Publication statusPublished - 1 Jun 2018

Cite this

van der Sluis, Wouter B. ; Pavan, Nicola ; Liguori, Giovanni ; Bucci, Stefano ; Bizic, Marta R. ; Kojovic, Vladimir ; Hess, Jochen ; Meijerink, Wilhelmus J.H.J. ; Mullender, Margriet G. ; Özer, Müjde ; Smit, Jan Maerten ; Buncamper, Marlon E. ; Krege, Susanne ; Djordjevic, Miroslav L. ; Trombetta, Carlo ; Bouman, Mark Bram. / Ileal vaginoplasty as vaginal reconstruction in transgender women and patients with disorders of sex development : an international, multicentre, retrospective study on surgical characteristics and outcomes. In: BJU International. 2018 ; Vol. 121, No. 6. pp. 952-958.
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title = "Ileal vaginoplasty as vaginal reconstruction in transgender women and patients with disorders of sex development: an international, multicentre, retrospective study on surgical characteristics and outcomes",
abstract = "Objective: To describe the surgical outcomes of ileal vaginoplasty in transgender women and patients with disorders of sex development (DSD). Patients and Methods: Transgender women and patients with DSD, who underwent ileal vaginoplasty at the VU University Medical Center Amsterdam, University Hospital Trieste, University Hospital Essen, and Belgrade University Hospital, were retrospectively identified. A chart review was performed, recording surgical technique, intraoperative characteristics, complications, and re-operations. Results: We identified a total of 32 patients (27 transgender and five non-transgender), with a median (range) age of 35 (6–63) years. Ileal vaginoplasty was performed as the primary procedure in three and as a revision procedure in the remaining 29. The mean (sd) operative time was 288 (103) min. The procedure was performed laparoscopically (seven patients) or open (25). An ileal ‘U-pouch’ was created in five patients and a single lumen in 27. Intraoperative complications occurred in two patients (one iatrogenic bladder damage and one intraoperative blood loss necessitating transfusion). The median (range) hospitalisation was 12 (6–30) days. Successful neovaginal reconstruction was achieved in all. The mean (sd) achieved neovaginal depth was 13.2 (3.1) cm. The median (range) clinical follow-up was 35 (3–159) months. In one patient a recto-neovaginal fistula occurred, which lead to temporary ileostomy. Introital stenosis occurred in four patients (12.5{\%}). Conclusion: Ileal vaginoplasty can be performed with few intra- and postoperative complications. It appears to have similar complication rates when compared to sigmoid vaginoplasty. It now seems to be used predominantly for revision procedures.",
keywords = "complications, gender dysphoria, reconstructive surgical procedures, sex reassignment procedures, transgender surgery, vaginoplasty",
author = "{van der Sluis}, {Wouter B.} and Nicola Pavan and Giovanni Liguori and Stefano Bucci and Bizic, {Marta R.} and Vladimir Kojovic and Jochen Hess and Meijerink, {Wilhelmus J.H.J.} and Mullender, {Margriet G.} and M{\"u}jde {\"O}zer and Smit, {Jan Maerten} and Buncamper, {Marlon E.} and Susanne Krege and Djordjevic, {Miroslav L.} and Carlo Trombetta and Bouman, {Mark Bram}",
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Ileal vaginoplasty as vaginal reconstruction in transgender women and patients with disorders of sex development : an international, multicentre, retrospective study on surgical characteristics and outcomes. / van der Sluis, Wouter B.; Pavan, Nicola; Liguori, Giovanni; Bucci, Stefano; Bizic, Marta R.; Kojovic, Vladimir; Hess, Jochen; Meijerink, Wilhelmus J.H.J.; Mullender, Margriet G.; Özer, Müjde; Smit, Jan Maerten; Buncamper, Marlon E.; Krege, Susanne; Djordjevic, Miroslav L.; Trombetta, Carlo; Bouman, Mark Bram.

In: BJU International, Vol. 121, No. 6, 01.06.2018, p. 952-958.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Ileal vaginoplasty as vaginal reconstruction in transgender women and patients with disorders of sex development

T2 - an international, multicentre, retrospective study on surgical characteristics and outcomes

AU - van der Sluis, Wouter B.

AU - Pavan, Nicola

AU - Liguori, Giovanni

AU - Bucci, Stefano

AU - Bizic, Marta R.

AU - Kojovic, Vladimir

AU - Hess, Jochen

AU - Meijerink, Wilhelmus J.H.J.

AU - Mullender, Margriet G.

AU - Özer, Müjde

AU - Smit, Jan Maerten

AU - Buncamper, Marlon E.

AU - Krege, Susanne

AU - Djordjevic, Miroslav L.

AU - Trombetta, Carlo

AU - Bouman, Mark Bram

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Objective: To describe the surgical outcomes of ileal vaginoplasty in transgender women and patients with disorders of sex development (DSD). Patients and Methods: Transgender women and patients with DSD, who underwent ileal vaginoplasty at the VU University Medical Center Amsterdam, University Hospital Trieste, University Hospital Essen, and Belgrade University Hospital, were retrospectively identified. A chart review was performed, recording surgical technique, intraoperative characteristics, complications, and re-operations. Results: We identified a total of 32 patients (27 transgender and five non-transgender), with a median (range) age of 35 (6–63) years. Ileal vaginoplasty was performed as the primary procedure in three and as a revision procedure in the remaining 29. The mean (sd) operative time was 288 (103) min. The procedure was performed laparoscopically (seven patients) or open (25). An ileal ‘U-pouch’ was created in five patients and a single lumen in 27. Intraoperative complications occurred in two patients (one iatrogenic bladder damage and one intraoperative blood loss necessitating transfusion). The median (range) hospitalisation was 12 (6–30) days. Successful neovaginal reconstruction was achieved in all. The mean (sd) achieved neovaginal depth was 13.2 (3.1) cm. The median (range) clinical follow-up was 35 (3–159) months. In one patient a recto-neovaginal fistula occurred, which lead to temporary ileostomy. Introital stenosis occurred in four patients (12.5%). Conclusion: Ileal vaginoplasty can be performed with few intra- and postoperative complications. It appears to have similar complication rates when compared to sigmoid vaginoplasty. It now seems to be used predominantly for revision procedures.

AB - Objective: To describe the surgical outcomes of ileal vaginoplasty in transgender women and patients with disorders of sex development (DSD). Patients and Methods: Transgender women and patients with DSD, who underwent ileal vaginoplasty at the VU University Medical Center Amsterdam, University Hospital Trieste, University Hospital Essen, and Belgrade University Hospital, were retrospectively identified. A chart review was performed, recording surgical technique, intraoperative characteristics, complications, and re-operations. Results: We identified a total of 32 patients (27 transgender and five non-transgender), with a median (range) age of 35 (6–63) years. Ileal vaginoplasty was performed as the primary procedure in three and as a revision procedure in the remaining 29. The mean (sd) operative time was 288 (103) min. The procedure was performed laparoscopically (seven patients) or open (25). An ileal ‘U-pouch’ was created in five patients and a single lumen in 27. Intraoperative complications occurred in two patients (one iatrogenic bladder damage and one intraoperative blood loss necessitating transfusion). The median (range) hospitalisation was 12 (6–30) days. Successful neovaginal reconstruction was achieved in all. The mean (sd) achieved neovaginal depth was 13.2 (3.1) cm. The median (range) clinical follow-up was 35 (3–159) months. In one patient a recto-neovaginal fistula occurred, which lead to temporary ileostomy. Introital stenosis occurred in four patients (12.5%). Conclusion: Ileal vaginoplasty can be performed with few intra- and postoperative complications. It appears to have similar complication rates when compared to sigmoid vaginoplasty. It now seems to be used predominantly for revision procedures.

KW - complications

KW - gender dysphoria

KW - reconstructive surgical procedures

KW - sex reassignment procedures

KW - transgender surgery

KW - vaginoplasty

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DO - 10.1111/bju.14155

M3 - Article

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SP - 952

EP - 958

JO - BJU International

JF - BJU International

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