Surgical Experience and Outcome Evaluation of Genital Gender Affirmation Surgery for Transgender Female in China: A Case Series.

IF 2 3区医学 Q2 SURGERY Aesthetic Plastic Surgery Pub Date : 2025-01-08 DOI:10.1007/s00266-024-04628-4

Guanhuier Wang, Xu Chang, Xin Yang, Runlei Zhao, Jiaying Qian, Ye Liu, Qiannan Xing, Bailin Pan

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Abstract

Background: Gender-affirming surgery (GAS) for transgender females developed relatively late and limited in China due to some reasons. To introduce GAS surgical experiences for Chinese transgender females is necessary.

Aims: To report surgical choices and experience including clitoral/urethral reconstruction, vaginoplasty, and vulvoplasty, and their outcomes.

Methods: A single-center, retrospective case series was conducted among transgender females who underwent GAS between September 2018 and March 2023. Surgical outcomes were evaluated including short-term and long-term complications. Scar-Q Scale, Female Sexual Function Index (FSFI), Amsterdam Hyperactive Pelvic Floor Scale-Women (AHPFS-W), and Female Genital Self-Imaging Scale (FGSIS) were carried out for outcome evaluation.

Results: Thirteen transgender females underwent GAS. Among them, 7 patients underwent sigmoid colon vaginoplasty, 3 patients underwent zero-depth vaginoplasty (ZDV), and 3 patients underwent vaginoplasty using skin flap (penile or scrotum). Postoperative follow-up showed that for sigmoid colon neo-vagina, vaginal length can reach 10-15 cm, with a width of about 2 fingers. For skin flap neo-vagina, the long-term vaginal length can maintain at around 8-10 cm, with a width of about 2 fingers. AHPFS-W outcome shows that patients undergoing sigmoid colon vaginoplasty and ZDV have relatively better pelvic floor muscle function. Patients undergoing skin flap vaginoplasty scored higher on the FGSIS, indicating a higher level of self-acceptance toward reconstructed genitalia.

Discussion: Factors like anatomical characteristics, sexual customs and cultural backgrounds may alter the choice of GAS techniques for Chinese transgender females. The GAS surgical experience specialized to Chinese transgender females is necessary to share.

Level of evidence iv: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

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中国跨性别女性生殖器性别确认手术的经验与效果评价：一个案例系列。

背景：针对跨性别女性的性别确认手术（Gender-affirming surgery， GAS）在中国由于某些原因发展相对较晚且有限。有必要向中国跨性别女性介绍GAS手术经验。目的：报道包括阴蒂/尿道重建、阴道成形术和外阴成形术在内的手术选择和经验，以及他们的结果。方法：对2018年9月至2023年3月期间接受GAS治疗的跨性别女性进行单中心、回顾性病例系列研究。评估手术结果，包括短期和长期并发症。采用Scar-Q量表、女性性功能指数（FSFI）、阿姆斯特丹盆底过度活跃量表-女性（AHPFS-W）和女性生殖器自我成像量表（FGSIS）进行结果评估。结果：13名变性女性接受了GAS治疗。其中，乙状结肠阴道成形术7例，零深度阴道成形术3例，皮瓣（阴茎或阴囊）阴道成形术3例。术后随访显示，乙状结肠新生阴道，阴道长度可达10- 15cm，宽度约2指。对于皮瓣新阴道，长期阴道长度可维持在8- 10cm左右，宽度约2指。AHPFS-W结果显示，乙状结肠阴道成形术和ZDV患者盆底肌功能相对较好。接受阴道皮瓣成形术的患者在FGSIS上得分较高，表明对重建生殖器的自我接受程度较高。讨论：解剖学特征、性习俗、文化背景等因素可能改变中国跨性别女性对GAS技术的选择。针对中国跨性别女性的GAS手术经验有必要分享。证据等级iv：本刊要求作者为每篇文章指定一个证据等级。有关这些循证医学评级的完整描述，请参阅目录或在线作者说明www.springer.com/00266。

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来源期刊

Aesthetic Plastic Surgery 医学-外科

CiteScore

4.40

自引率

25.00%

发文量

479

审稿时长

3 months

期刊介绍： Aesthetic Plastic Surgery is a publication of the International Society of Aesthetic Plastic Surgery and the official journal of the European Association of Societies of Aesthetic Plastic Surgery (EASAPS), Società Italiana di Chirurgia Plastica Ricostruttiva ed Estetica (SICPRE), Vereinigung der Deutschen Aesthetisch Plastischen Chirurgen (VDAPC), the Romanian Aesthetic Surgery Society (RASS), Asociación Española de Cirugía Estética Plástica (AECEP), La Sociedad Argentina de Cirugía Plástica, Estética y Reparadora (SACPER), the Rhinoplasty Society of Europe (RSE), the Iranian Society of Plastic and Aesthetic Surgeons (ISPAS), the Singapore Association of Plastic Surgeons (SAPS), the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the Egyptian Society of Plastic and Reconstructive Surgeons (ESPRS), and the Sociedad Chilena de Cirugía Plástica, Reconstructiva y Estética (SCCP). Aesthetic Plastic Surgery provides a forum for original articles advancing the art of aesthetic plastic surgery. Many describe surgical craftsmanship; others deal with complications in surgical procedures and methods by which to treat or avoid them. Coverage includes "second thoughts" on established techniques, which might be abandoned, modified, or improved. Also included are case histories; improvements in surgical instruments, pharmaceuticals, and operating room equipment; and discussions of problems such as the role of psychosocial factors in the doctor-patient and the patient-public interrelationships. Aesthetic Plastic Surgery is covered in Current Contents/Clinical Medicine, SciSearch, Research Alert, Index Medicus-Medline, and Excerpta Medica/Embase.