Database Tracking in Gender-Affirming Surgery: Are Patients Falling Through the Cracks?

Background: This study sought to examine risk factors for venous thromboembolism in transfeminine vaginoplasty. Secondarily, the authors outline reasons why patients are not adequately classified for research purposes despite using relevant queried codes.

Methods: Transgender patients undergoing vaginoplasty were identified with diagnostic and procedure-specific codes using a national surgical database from 2010 through 2019.

Results: There were 457 transgender vaginoplasties performed, with 24 wound dehiscences, 17 unplanned reoperations, and 12 surgical site infections. With zero cases of venous thromboembolism, risk factor analysis was deferred.

Conclusions: Heterogeneity in coding practices for gender-affirming surgery led to an uncharacteristically small cohort of transfeminine vaginoplasty patients captured in the database. Current diagnostic and procedure-specific codes are nonspecific and unbundled, hindering accurate assessment of the incidence of standard surgical complications.