Sex Reassignment Surgery

性别重新分配手术
  • 文章类型: Journal Article
    这项研究的目的是分享我们的带蒂股前外侧皮瓣(ALTf)球囊成形术技术的初步结果,我们认为这是土耳其单一中心的第一个报告病例系列。一项横断面研究,包括在我们诊所接受带蒂ALTf球囊成形术的所有病例,2015年1月至2019年12月,设计。人口统计数据,记录病例特征和手术细节,包括并发症.我们26例的平均年龄为30(28-34)岁。平均阴茎长和直径分别为15.07±0.98cm和3.9±0.34cm,分别。通过触摸基数来评估触觉,新阴茎的语料库和尖端在17个(65.4%)中显示出响应,7例(26.9%)和2例(7.7%),分别。在我们所有病例中,有14例(53.8%)没有并发症报告。然而,在12例(46.1%)中,虽然没有术中并发症发生;术后并发症观察为Clavien-2(3.8%),Clavien-3a(3.8%)和Clavien-3b(71%)。术后满意率为77.14%(38-94)。尽管相关研究有限,除了低并发症发生率和高满意结果外,通过通向一个隐藏的捐赠地点,带蒂ALTf可以作为一种首选的球囊成形术技术,特别是在具有宗教或文化敏感性的变性人中。
    The aim of this study is to share our preliminary outcomes of the pedicled Antero Lateral Thigh flap (ALTf) phalloplasty technique, which we presume to be the first reported case series of a single center from Turkey. A cross-sectional study, comprising all cases who underwent pedicled ALTf phalloplasty in our clinic, between January 2015 and December 2019, was designed. Demographic data, case characteristics and surgical details including complications were recorded. The mean age of our 26 cases was 30 (28-34) years. The mean penile length and diameter were 15.07 ± 0.98 cm and 3.9 ± 0.34 cm, respectively. Tactile sensation was evaluated by touching the radix, corpus and tip of the neo-phallus showing response in 17 (65.4%), 7 (26.9%) and 2 (7.7%) of the cases, respectively. In 14 (53.8%) of all our cases no complication was reported at all. However, in 12 (46.1%) cases, although no intraoperative complication occurred; postoperative complications were observed as Clavien-2 (3.8%), Clavien-3a (3.8%) and Clavien-3b (71%). Postoperative satisfaction rates were found 77.14% (38-94). Although relevant studies are limited, in addition to low complication rates and high satisfactory outcomes, by leading to a concealable donor site, the pedicled ALTf can be used as a preferred phalloplasty technique, especially in transmen with religious or cultural sensibility.
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  • 文章类型: Case Reports
    背景:性别重新分配手术(SRS)是转换为男性至女性变性人所需性别的必要步骤。这项研究的重点是SRS后出现的罕见并发症,旨在强调与此手术相关的潜在并发症。
    方法:本报告描述了一名49岁变性女性,有SRS病史,10年后出现血性腹泻和新阴道出血。结肠镜检查显示与溃疡性结肠炎相容的特征,活检证实了这一点。
    结论:这种现象的不可预测的临床过程可能促使外科医生重新考虑使用直肠乙状结肠来产生新阴道。此病例报告强调了当直肠乙状结肠段用于新阴道构造时,对SRS后的变性女性进行长期监测胃肠道并发症的必要性。
    BACKGROUND: Sex reassignment surgery (SRS) is a necessary step in transitioning into the desired gender for male-to-female transgender individuals. This study focuses on a rare complication developed following SRS, aiming to highlight potential complications associated with this procedure.
    METHODS: This report describes a 49-year-old transgender woman with a history of SRS who developed bloody diarrhea and neovaginal bleeding 10 years later. A colonoscopy revealed features compatible with ulcerative colitis, which was confirmed by a biopsy.
    CONCLUSIONS: The unpredictable clinical course of this phenomenon may prompt surgeons to reconsider the use of a rectosigmoid colon to create a neovagina. This case report underscores the necessity of long-term monitoring for gastrointestinal complications in transgender women post-SRS when a rectosigmoid colon segment is utilized for neovaginal construction.
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  • 文章类型: Journal Article
    背景:寻求性别确认手术(GAS)的变性人通常被精神卫生专业人员(MHP)拒绝或推迟。关于GAS看门的研究主要在全球北部进行,主要侧重于卫生专业人员的观点。这个来自印度的案例研究包括卫生专业人员,社区,倡导者,和激进主义者的观点,为GAS中的MHP把关提供新的证据。该研究旨在研究权力和性别在印度GAS的MHP把关中的作用。
    方法:定性的多方法案例研究,包括对关键线人访谈的主题分析(n=9)和使用政策三角框架的政策分析。
    结果:卫生专业人员和变性人参与建设,性能,和性别的复制表明印度性别规范性的持续存在,这使MHP能够把关。然而,有证据表明,有一些迹象表明,从双元性转变为文化上可理解且历史上熟悉的“三元性”。
    结论:要了解MHP看门,有必要在MHP运作的更大的性别社会建构中,将这个生物力量的例子背景化。从双生物到“三生物”的过渡使寻求GAS的变性人的MHP成为可能。这有可能造成新形式的与性别有关的压迫,例如性别二元和“第三性别”之间的新层次结构和阶级差异。
    BACKGROUND: Transgender individuals seeking gender-affirming surgeries (GAS) are often denied or delayed by mental health professionals (MHPs). Studies on the gatekeeping of GAS have been mainly conducted in the Global North and primarily focus on the perspectives of health professionals. This case study from India incorporates health professional, community, advocate, and activist perspectives to contribute new evidence about MHP gatekeeping in GAS. The study aims to examine the role of power and gender in MHP gatekeeping of GAS in India.
    METHODS: A qualitative multi-method case study including thematic analyses of key informant interviews (n = 9) and policy analysis using the policy triangle framework.
    RESULTS: Health professionals and transgender persons participate in the construction, performance, and reproduction of gender indicating the persistence of gender normativity in India which enables gatekeeping by MHPs. However, evidence suggests some signs of a change from binormativity to a culturally intelligible and historically familiar \"trinormativity\".
    CONCLUSIONS: To understand MHP gatekeeping, there is a need to contextualise this example of biopower within the larger social construction of gender within which MHPs operate. A transition from binormativity to \"trinormativity\" enables MHP gatekeeping of transgender persons seeking GAS. This risks creating new forms of gender-related oppression, such as new hierarchies and class differences between the gender binary and the \"third gender\".
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  • 文章类型: Case Reports
    背景:纤维发育不良(FD)是一种良性的骨骼发育障碍,导致正常骨骼组织被过量的纤维组织和低分化的成骨细胞所取代。骨内黄色瘤是良性骨内肿瘤生长,显微镜下表现为脂质泡沫组织细胞的存在,通常伴随皮质扩张或破坏。虽然FD通常发生在颅面骨,颅骨或面部骨骼的原发性骨内黄色瘤极为罕见。虽然有两个不同的条件,当发生在面部骨骼中时,每个可能难以在CT成像上区分。
    方法:我们报告了一例在颅面CT上偶然发现的额骨病变,最初被认为是FD。该发现是在一名55岁的跨性别女性中进行的,该女性在接受多程序面部女性化手术之前出生时被分配为男性。
    结果:临床特征,放射学发现,和治疗进行了讨论。术后,患者没有继发于面部女性化手术或眼眶病变活检手术的后遗症。植骨在CT成像上表现稳定,虽然FD似乎没有完全解决。
    结论:此类病变的诊断具有挑战性,可能需要影像学和组织病理学评估。就像这个病人一样,骨内黄色瘤也可能被误诊为其他良性病变,如FD。在大多数已知案例中,手术干预导致完全缓解而不复发的病变。
    BACKGROUND: Fibrous dysplasia (FD) is a benign developmental disorder of the bone that causes normal skeletal tissue to be replaced by excess fibrous tissue and poorly differentiated osteoblasts. Intraosseous xanthomas are benign intraosseous tumor growths characterized microscopically by the presence of lipid-laden foamy histiocytes, often with cortical expansion or disruption. Although FD commonly occurs in craniofacial bones, primary intraosseous xanthomas of the skull or facial skeleton are extremely rare. Although 2 distinct conditions, each may be difficult to differentiate on CT imaging when occurring in the facial skeleton.
    METHODS: We report a case of an incidental finding on craniofacial CT of a frontal bone lesion originally thought to be FD. The finding was in a 55-year-old transgender woman who was assigned male at birth before receiving multiprocedural facial feminization surgery.
    RESULTS: The clinical features, radiological findings, and treatment are discussed. Postoperatively, the patient had no sequelae secondary to facial feminization surgery or to the orbital lesion biopsy procedure. Bone graft appeared stable on CT imaging, although FD did not appear to resolve completely.
    CONCLUSIONS: Diagnosis of such lesions is challenging and may require both radiographic and histopathologic assessment. As in the case of this patient, intraosseous xanthomas may also be misdiagnosed as other benign lesions such as FD. In most known cases, surgical intervention leads to complete resolution without recurrence of the lesion.
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  • 文章类型: Journal Article
    由于其初始设计和用于临时覆盖严重的全厚度烧伤缺陷,Integra®(IntegraLifeSciences)真皮再生模板已越来越多地用于全身,在血管供应不足和适当愈合的次优条件下覆盖伤口床的成功结果。在这项研究中,我们报告了一个机构病例系列和结果,即确认性别的阴道成形术翻修术用于阴道延长或通过放置Integra®重开管,以在认为伤口条件欠佳的情况下帮助优化伤口床用于随后的皮肤移植.作者机构的一名外科医生(JM)对接受此技术的患者进行了回顾性图表审查。人口统计,阴道深度,记录并比较并发症。到目前为止,我们的患者群体包括178例原发性阴道成形术,其中9名需要修订的人采用了这种方法。平均翻修年龄为47±13.5岁,体重指数平均值为31±4.1。所有患者均有合并症,其中5人曾吸烟。8名患者先前进行了没有Integra®的翻修,平均为1.89±1.76,首次修订时间平均为15.89±14.2个月。Integra®报告后没有长期并发症,大多数患者不需要进一步修订。随访平均8.48±8.66个月。Integra®翻修后平均增加6.77±5.35cm(前4.92±4.1cm,后12.54±3.07cm)。Integra®+全层皮肤移植后的最终深度平均值为13.34±4.65cm。总的来说,深度增益平均值为7.48±5.77厘米;总计,7例患者在翻修后深度增加,平均接受78%的皮肤移植。总的来说,Integra®为具有复杂伤口床的翻修阴道成形术提供了一种替代选择,可能有助于移植前的愈合过程。
    Since its initial design and use for the temporary coverage of severe full-thickness burn defects, Integra® (Integra LifeSciences) Dermal Regeneration Template has been increasingly used all over the body, yielding successful results in coverage of wound beds with insufficient vascularity and suboptimal conditions for proper healing. In this study, we report an institutional case series and outcomes of gender-affirming vaginoplasty revision for vaginal lengthening or reopening of the canal via placement of Integra® to assist in optimizing the wound bed for subsequent skin grafting when wound conditions were deemed to be suboptimal. A retrospective chart review was conducted in patients who underwent this technique by a single surgeon (JM) at the authors\' institution. Demographics, vaginal depth, and complications were recorded and compared. Our patient population thus far includes 178 primary vaginoplasties, of which 9 of those needing revision were treated with this approach. The age at revision mean was 47 ± 13.5 years, and the body mass index mean was 31 ± 4.1. All patients had comorbidities and five were former smokers. Eight patients had prior revision conducted without Integra®, with a mean of 1.89 ± 1.76 and the time to first revision mean was 15.89 ± 14.2 months. No long-term complications after Integra® reported and most of the patients did not require further revision. The follow-up mean was 8.48 ± 8.66 months. A mean of 6.77 ± 5.35 cm was gained after the Integra® revision (4.92 ± 4.1 cm before versus 12.54 ± 3.07 cm after). The final depth after Integra® + full-thickness skin graft mean was 13.34 ± 4.65 cm. Overall, the depth gain mean was 7.48 ± 5.77 cm; in total, seven patients gained depth after revision with an average of 78% skin graft take. Overall, Integra® presents an alternative option for revision vaginoplasty with complicated wound beds potentially aiding in the healing process before grafting.
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  • 文章类型: Journal Article
    背景:保留生育力(FP)是跨性别患者护理的一个重要方面,在这些患者中,性别确认药物治疗(GAT)可能会在青春期完成之前开始。虽然总体上很少有研究可以用来指导有关GAT的长期影响的对话,有人担心GAT可能会对生育率产生负面影响。先前的研究表明,该人群中FP的利用率较低,避免延迟启动GAT被认为是上述FP的最常见原因之一。减轻GAT启动延迟的策略可能有助于提高FP利用率,维护未来家庭建设的选择。
    目的:描述我们机构在睾丸精子提取(TESE)用于FP和醋酸Histrelin(Supprelin)皮下植入用于GAT开始的经验。
    方法:回顾性回顾了2010年至2022年在我们机构进行的跨女性青少年,他们在Supprelin置入GAT(FP/SP)时接受了FPTESE。感兴趣的结果包括成功的精子提取,年龄在第一次访问我们机构的跨性别多专业服务健康诊所(GeMS),FP/SP时的年龄,睾丸体积,FP/SP时的Tanner阶段,以及规定GnRH激动剂(GnRHa)治疗时的年龄。睾酮,LH,FSH,还获得了在组合FP/SP之前的抑制素B值。
    结果:根据内分泌学会指南,2017年至2022年有10例患者在GnRHa处方后接受FP/SP。所有患者均成功获取和储存精子。FP/SP的中位年龄为14岁5.5个月(范围12y5m-16y8m)。从GnRHa处方到FP/SP的中位时间为两个月(范围2-5m)。FP/SP时的平均睾丸体积为13.2cc(SD3.38cc,范围8-17cc),中位坦纳分期为IV期(III-V范围)。平均睾酮水平为301.60(SD173.04),LH3.00(SD1.25),FSH3.33(SD1.71),抑制素B208.50(SD87.44)。
    结论:对于接受Histrelin植入的跨性别青年,进行FPTESE是可行的,导致启动GAT的短暂延迟。睾丸体积和内分泌标志物可以提供术前了解在TESE期间成功取出精子的可能性。需要确定哪些患者将成功获取精子,以确保为提供者提供最佳咨询和明智的决策,患者和家属。
    Fertility preservation (FP) is an important aspect of the care of transgender patients in whom Gender Affirming Medical Treatment (GAT) may begin before puberty is completed. While there are overall few studies that can be used to guide conversations about long-term effects of GAT, there are concerns that GAT could negatively impact fertility. Prior studies have shown low utilization of FP in this population, with avoidance of delay in starting GAT cited as one of the most common reasons for foregoing FP. It is possible that strategies to mitigate delay in commencement of GAT can facilitate higher FP utilization, maintaining options for future family building.
    To describe our institution\'s experience with Testicular Sperm Extraction (TESE) for FP and Histrelin Acetate (Supprelin) Subcutaneous Implantation for GAT commencement.
    A retrospective review of transfeminine adolescents at our institution from 2010 to 2022 who underwent TESE for FP at the time of Supprelin placement for GAT (FP/SP). Outcomes of interest included successful sperm retrieval, age at first visit to our institution\'s Transgender Multispecialty Service Health clinic (GeMS), age at time of FP/SP, testicular volume, and Tanner stage at time of FP/SP, and age when GnRH agonist (GnRHa) therapy was prescribed. Testosterone, LH, FSH, and Inhibin B values prior to combination FP/SP were also obtained.
    Ten patients from 2017 to 2022 underwent FP/SP after prescription of GnRHa based on Endocrine Society Guidelines. Successful sperm retrieval and storage was achieved in all patients. Median age at FP/SP was fourteen years 5.5 months (range 12y5m-16y8m). Median time from GnRHa prescription to FP/SP was two months (range 2-5 m). Mean testicular volume at time of FP/SP was 13.2 cc (SD 3.38 cc, range 8-17 cc), and median Tanner Stage was IV (range III-V). Average testosterone level was 301.60 (SD 173.04), LH 3.00 (SD 1.25), FSH 3.33 (SD 1.71), Inhibin B 208.50 (SD 87.44).
    Performing TESE for FP is feasible for transgender youth undergoing Histrelin implant placement, leading to short delays in starting GAT. Testicular volume and endocrine markers can provide preoperative insight into likelihood of successful sperm retrieval during TESE, are needed to identify which patients will have successful sperm retrieval to ensure optimal counseling and informed decision making for providers, patients and families.
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  • 文章类型: Journal Article
    随着性别确认手术的进行,已经开发了新技术来满足患者的需求,包括最近有报道称,一些性别确认程序被合并为一次手术。这样的发展可以为患者和提供者提供若干优点。然而,尚不清楚将这些手术结合使用是否会影响患者安全和手术病例计划因素.为了解决这个问题,我们比较了独立和联合性别确认手术的并发症发生率、住院时间和手术时间(例如,子宫切除术和双侧乳房切除术,隆胸,和阴道成形术)在2005年至2019年之间在国家手术质量改进计划数据库中进行。有1857年独立的乳腺切除术,826个独立的子宫切除术,和30例合并的病例。有379例阴道成形术,648次隆胸,以及31例合并的病例。没有证据表明接受联合手术和独立手术的患者之间的总体健康状况存在差异。双样本比例测试没有发现在独立和联合手术之间经历的任何并发症的显着差异。同样,双样本t检验未发现独立和联合男性化手术在住院时间和手术相遇时间方面存在显著差异.结合隆胸和阴道成形术,然而,平均节省了97.86分钟(p=.000)的操作时间。这些结果表明,对于希望进行多种性别确认程序的个人来说,结合性别确认程序可能是安全可行的选择,甚至可能是患者和从业人员的有利选择。
    As gender-affirming surgeries are being performed, new techniques have been developed to meet patient desires, including recent reports of several gender-affirming procedures being combined into a single operative encounter. Such a development may provide several advantages to both patients and providers. However, it is less clear whether combining these procedures affects patient safety and surgical case planning factors. To address this, we compared the complication rates and the length of hospital stay and operative time for standalone and combined gender-affirming procedures (e.g., hysterectomy and bilateral mastectomy, breast augmentation, and vaginoplasty) performed between 2005 and 2019 in the National Surgical Quality Improvement Program database. There were 1857 standalone mastectomies, 826 standalone hysterectomies, and 30 cases where they were combined. There were 379 vaginoplasties, 648 breast augmentations, and 31 cases where they were combined. There was no evidence of differences in overall health status between those undergoing combined and standalone procedures. Two-sample proportion testing did not find significant differences in any of the complications experienced between standalone and combined procedures. Similarly, two-sample t-tests did not find significant differences in the length of the hospital stays nor in the length of the operative encounter between standalone and combined masculinizing surgeries. Combining breast augmentation and vaginoplasty, however, saved an average of 97.86 min (p = .000) of operating time. These results suggest that combining gender-affirming procedures may be a safe and viable option for individuals who desire multiple gender-affirming procedures and may even be an advantageous option for patients and practitioners alike.
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  • 文章类型: Case Reports
    面部女性化手术由各种颅颌面外科手术组成,越来越受到男性对女性变性人患者和寻求面部女性化的人的追捧。面部女性化手术在缓解性别焦虑方面可以发挥突出作用。考虑到近年来执行的性别确认程序有所增加,广泛的技术知识基础,结果,面部女性化手术的挑战应该由提供这些程序的外科医生来确定。我们的评论旨在批判性地评估当前文献,并为性别确认外科实践的未来进展提供信息。此外,我们详细介绍了一个具有代表性的案例,以说明资深作者对完全面部女性化的方法。
    PubMed的全面文献检索,EMBASE,和Cochrane数据库是针对截至2020年6月发布的研究进行的,使用以下搜索词进行的:“面部”或“面部”或“颅面”和“女性化”或“女性化手术”或“性别重新分配”或“性别确认手术”或“性别确认手术”。“程序数据,结果,患者年龄,随访时间,并发症,并收集患者满意度。数据按面部三分法分类,然后按面部特征进一步分层。
    我们的搜索产生了388篇文章。30篇文章符合我们的纳入标准,其中,审查中包括23篇文章。我们提取了3554名年龄在18至73岁之间的患者的主要数据,这些患者总共接受了8506次手术。大多数程序都针对上面部三分之一(发际线,前额,和眉毛),占全部手术的49.1%。按面部特征进一步分类显示,最常见的特征是额头(占手术的34.6%),其次是鼻子(12.8%)和下巴(12.2%)。在使用定量措施来衡量患者报告结果的研究中,满意度很高。
    面部女性化手术似乎是安全的,无论是在单一阶段还是分阶段进行。面部女性化程序后,患者报告满意度高,性别一致性更好。需要进一步的研究来建立最佳的手术实践,并在平均随访时间之外评估患者的满意度,并确定寻找辅助程序的频率。
    Facial feminization surgery is composed of a variety of craniomaxillofacial surgical procedures that are increasingly sought after by male-to-female transgender patients and by those seeking feminization of the face. Facial feminization surgery can play a prominent role in alleviating gender dysphoria. In consideration of an observed increase in gender-affirming procedures performed in recent years, a broad knowledge base in the techniques, outcomes, and challenges of facial feminization surgery should be established by surgeons offering these procedures. Our review was designed to critically appraise the current literature and inform future advancements in gender-affirming surgical practice. In addition, we detail a representative case to illustrate the senior author\'s approach to full facial feminization.
    A comprehensive literature search of the PubMed, EMBASE, and Cochrane databases was conducted for studies published through June 2020 using following the search terms: \"Face\" OR \"facial\" OR \"craniofacial\" AND \"Feminization\" OR \"Feminization Surgery\" OR \"Gender Reassignment\" OR \"Gender Affirming Surgery\" OR \"Gender Confirmation Surgery.\" Data on procedures, outcomes, patient age, follow-up time, complications, and patient satisfaction were collected. The data were categorized by facial thirds and then further stratified by facial feature.
    Our search yielded 388 articles. Thirty articles fit our inclusion criteria, and of these, 23 articles were included in the review. We extracted primary data pertaining to 3554 patients with an age range of 18 to 73 who underwent 8506 total procedures. Most of the procedures addressed the upper facial third (hairline, forehead, and brow), comprising 49.1% of total procedures performed. Further categorization by facial feature revealed that the most commonly addressed feature was the forehead (34.6% of procedures), followed by the nose (12.8%) and the chin (12.2%). In studies that used quantitative measures to gauge patient-reported outcomes, satisfaction was high.
    Facial feminization surgery seems to be safe, whether it is conducted in a single stage or as a staged procedure. Patients report high satisfaction and better gender congruency after facial feminization procedures. Further research is needed to establish best surgical practice and gauge patient satisfaction beyond the length of average follow-up and determine the frequency with which adjunctive procedures are sought out.
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  • 文章类型: Journal Article
    评估接受性别确认手术(GAS)的男女变性人的盆底肌肉(PFM)的强度和电活动。
    病例系列研究于2016年10月至2018年8月进行。变性女性,他们被安排在GAS,参与研究。志愿者接受PFM的临床评估,然后在术前进行数字触诊(PERFECT方法)和肌电图检查,15,和GAS后30天。他们回应了国际尿失禁问卷咨询-尿失禁(UI)-简短表格,以评估UI对生活质量的影响以及与泌尿有关的问题,肛门直肠,性症状。煤气发生后15天,患者被指示在家进行会阴锻炼,一天两次.
    研究样本包括15名变性女性,平均年龄为30.6岁(SD=6.7)。中位力量和持续肌肉收缩持续时间(PERFECT)下降,在前GAS和GAS后15天之间的电肌肉活动(RMSmean和RMSmax)(p<0.05)。然而,这些参数在GAS后15-30天之间增加(p<0.05)。此外,六名患者表现出GAS前UI,手术后继续,尿急症状恶化,夜尿症和排尿后渗漏改善。
    强度,持续的肌肉收缩持续时间,和PFM电活动可能在GAS后15天下降,在手术后的第一个月恢复到GAS前的值。
    To assess the strength and electrical activity of the pelvic floor muscles (PFMs) of male-to-female transgender individuals submitted to gender-affirming surgery (GAS).
    A case series study was conducted from October 2016 to August 2018. Transgender women, who were scheduled for GAS, participated in the study. The volunteers were submitted to a clinical evaluation of the PFM followed by digital palpation (PERFECT method) and electromyography in the preoperative, 15, and 30 days after GAS. They responded to the International Consultation on Incontinence Questionnaire-Urinary Incontinence (UI)-Short Form to evaluate the effect of UI on quality of life and to questions related to the urinary, anorectal, and sexual symptoms. Fifteen days after the GAS, patients were instructed to perform perineal exercises at home, twice a day.
    The study sample consisted of 15 transgender women with an average age of 30.6 (SD = 6.7) years. There was a decline in median strength and sustained muscle contraction duration (PERFECT), in the electrical muscle activity (RMSmean and RMSmax) between pre-GAS and 15 days after GAS (p < 0.05). However, there was an increase in these parameters between 15 and 30 days after GAS (p < 0.05). Moreover, six patients exhibited pre-GAS UI, which continued after surgery, with a worsening of urgency symptoms and improvement in nocturia and postmicturition leakage.
    Strength, sustained muscle contraction duration, and PFM electrical activity may decline 15 days after GAS, returning to pre-GAS values in the first month after surgery.
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  • 文章类型: Case Reports
    背景:囊性纤维化(CF)是一种遗传性肺部和肺外疾病,在男性和女性中同等发生。然而,长期以来,性别之间的发病率和死亡率存在差异。同样,据报道,哮喘的疾病严重程度也存在性别差异.迄今为止所做的研究指出,在这两种情况下,雌激素可能是导致肺部结局性别差异的原因。
    方法:这里,我们描述了一例CF合并哮喘/变应性支气管肺曲霉病(ABPA)患者正在接受性别重新分配治疗(男性-女性),以及在外源性雌激素剂量增加的情况下,这对她的肺功能和肺加重频率的负面影响.
    结论:该病例提出了雌激素与肺部预后恶化之间存在联系的可能性,并且需要进一步研究患有CF和/或哮喘/ABPA的跨性别个体以及接受高剂量雌激素治疗的患者其他适应症。
    BACKGROUND: Cystic Fibrosis (CF) is a hereditary pulmonary and extra-pulmonary disease that occurs equally in men and women. However, a difference in morbidity and mortality rates between the sexes has been long documented. Similarly, a sex-disparity in disease severity has been reported in asthma as well. Studies done to date point to estrogen as a possible cause of this sex disparity in pulmonary outcomes in both conditions.
    METHODS: Here, we describe a case of a patient with CF and asthma/allergic bronchopulmonary aspergillosis (ABPA) undergoing sex reassignment therapy (male-to-female) and the negative impact it had on her lung function and frequency of pulmonary exacerbations in the context of increasing doses of exogenous estrogen.
    CONCLUSIONS: This case raises the possibility of a link between estrogen and worsening pulmonary outcomes and the need for further studies into transgender individuals with CF and/or asthma/ABPA as well as those undergoing high dose estrogen therapy for other indications.
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