■性别确认双侧睾丸切除术(GABO)可以作为独立手术(sGABO)或与性别确认阴道成形术(vGABO)同时完成。GABO被假定为减少性别确认激素治疗(GAHT)剂量并减少性别焦虑,但是这些现象在医学文献中没有经验描述。
■本研究的主要目的是描述sGABO和vGABO后GAHT剂量的变化。次要目的是评估sGABO患者的术前决策优先级和术后满意度。
回顾性图表回顾确定了204例完成GABO手术的患者(64%的患者)或与阴道成形术同时完成的患者(36%)。患者人口统计数据,手术结果,记录术前和术后的GAHT剂量数据。患者填写了一份意见问卷,以评估决策优先事项,以及术后满意度和生活质量指标的变化。
■主要结果包括雌二醇的术前和术后剂量,黄体酮,和螺内酯.次要结果包括sGABO患者的优先级,对SGABO满意,sGABO和vGABO患者生活质量指标的变化,和sGABO对未来患者的建议。
■sGABO和vGABO患者在所有三个GAHT评估中经历了统计学上显著的剂量减少:雌二醇,黄体酮,和螺内酯(P<0.05)。所有患者术后停用螺内酯。两组患者的GABO相关并发症均为零。患者问卷调查显示,sGABO患者优先考虑降低内源性睾丸激素并降低他们的GAHT,这在他们决定在阴道成形术之前接受sGABO的决定中是最重要的。大多数sGABO患者报告所有9项生活质量指数均有所改善。没有一个sGABO患者会向等待阴道成形术的朋友推荐使用sGABO。
■对于对阴道成形术感兴趣的患者,SGABO可以作为一个更直接的,低风险,GABO带来的中间步骤,包括显著的GAHT药物减少和性别焦虑缓解。
■本研究全面评估了GABO对患者的影响,将经验数据与主观患者反馈相结合。局限性包括回顾性设计和使用未经验证的调查问题。
阴道成形术GABO是一种可行的选择,可以更迅速地缓解性别焦虑,并减少对性别确认阴道成形术感兴趣的患者的GAHT药物。
UNASSIGNED: Gender-affirming bilateral orchiectomy (GABO) may be completed as either a standalone procedure (sGABO) or at the same time as gender-affirming vaginoplasty (vGABO). GABO is postulated to decrease gender-affirming hormone therapy (GAHT) dosages and reduce gender dysphoria, but these phenomena are not empirically described in the medical literature.
UNASSIGNED: The primary aim of this study was to describe changes in GAHT dosages after sGABO and vGABO. A secondary aim was to assess sGABO patients\' preoperative decision-making priorities and postoperative satisfaction.
UNASSIGNED: A retrospective chart review identified 204 patients who completed GABO as either a standalone procedure (64% of patients) or at the same time as vaginoplasty (36%). Patient demographic data, surgical outcomes, and pre- and postoperative GAHT dosage data were recorded. Patients completed an opinion questionnaire to assessed decision-making priorities, as well as postoperative satisfaction and changes in quality-of-life measures.
UNASSIGNED: Primary outcomes included pre- and postoperative dosages of estradiol, progesterone, and spironolactone. Secondary outcomes included sGABO patient priorities, satisfaction with sGABO, changes in quality-of-life measures between sGABO and vGABO patients, and sGABO recommendations to future patients.
UNASSIGNED: The sGABO and vGABO patients experienced a statistically significant dosage reduction in all three GAHT assessed: estradiol, progesterone, and spironolactone (P < .05). All patients discontinued spironolactone postoperatively. Zero complications related to GABO were recorded for patients in either group. The patient questionnaire revealed that sGABO patients prioritize decreasing endogenous testosterone and reducing their GAHT as most important in their decision to undergo sGABO prior to vaginoplasty. A majority of sGABO patients reported improvement in all nine quality-of-life indices. None of the sGABO patients would recommend against sGABO to a friend who is waiting for vaginoplasty.
UNASSIGNED: For patients who are interested in vaginoplasty, sGABO may serve as a more immediate, low-risk, intermediary step that comes with the benefits of GABO, including significant GAHT medication reduction and gender dysphoria relief.
UNASSIGNED: This study offers a comprehensive evaluation of the impact of GABO on patients, combining empirical data with subjective patient feedback. Limitations include the retrospective design and the use of unvalidated survey questions.
UNASSIGNED: Prevaginoplasty GABO is a viable option to more immediately alleviate gender dysphoria and reduce GAHT medications for patients who are interested in gender-affirming vaginoplasty.