■大多数跨性别妇女都要求通过外阴阴道成形术进行确认性别的生殖器手术。然而,生殖器脱垂等长期并发症尚不清楚.通过这次系统的审查,我们的目的是概述已发表的与男性-女性跨性别者阴道成形术后生殖器脱垂相关的结果,包括患病率,已确定的风险因素,和治疗。
■我们纳入了1995年至今所有报告外阴阴道成形术后生殖器脱垂发生率的研究。仅包括针对跨性别人群的研究。主要结果是生殖器脱垂率。次要结局包括外阴阴道成形术后生殖器脱垂的危险因素和治疗。文章选择由两名独立的审稿人进行。
■二十四项研究,涉及3166名患者,对提供足够数据的数据进行了分析。外阴阴道成形术时的平均年龄为37.7岁。平均随访时间为22.5mo。大多数研究是低至中等质量的回顾性病例系列。阴茎皮肤倒置技术是最常用的方法(在3166名患者中占85%)。阴茎皮肤倒置技术的脱垂患病率为0%至7%,肠道阴道成形术的脱垂患病率为1.6%至22.7%。在巩固成果后,观察到总比率为2.7%。具体来说,阴茎倒置技术亚组的脱垂率为2.5%,而肠道源性新阴道亚组的发生率为3.5%。确定的唯一重要风险因素是手术时的高体重指数。预防新阴道脱垂的术中最常用的技术包括固定骶棘韧带,再加上系统的阴道填塞.很少有病例报告涉及新阴道脱垂的手术治疗,主要使用开腹或腹腔镜方法。这些方法均未考虑经阴道或会阴入路。没有关于使用阴道假体的建议。
■男性-女性变性患者的新阴道脱垂仍然是一种罕见的并发症,但随着变性人年龄的增长,它的重要性越来越大。有关预防技术和治疗的信息很少,需要进一步探索,因其罕见的发生而受阻。
■男性-女性变性患者的新阴道脱垂是一种罕见的并发症,唯一公认的危险因素是高体重指数。然而,随着变性人人口的老龄化,它的重要性越来越大。长期并发症,预防技术,这些脱垂的管理需要通过进一步的研究来探索。
UNASSIGNED: Most trans women are requesting a gender affirming genital surgery by vulvovaginoplasty. However, long-term complications such as genital
prolapse are unknown. Through this systematic review, our objective was to provide an overview of the published outcomes related to genital prolapse after vaginoplasty in male-to-female transgender individuals, including prevalence, identified risk factors, and treatment.
UNASSIGNED: We included all studies reporting genital
prolapse rates following vulvovaginoplasty from 1995 to the present. Only studies that focused on the transgender population were included. The primary outcome was the genital
prolapse rate. The secondary outcomes included risk factors and treatment of genital
prolapse after vulvovaginoplasty. Article selection was performed by two independent reviewers.
UNASSIGNED: Twenty-four studies, involving 3166 patients, that presented sufficient data were analyzed. The mean age at the time of vulvovaginoplasty was 37.7 yr. The mean follow-up time was 22.5 mo. Most of the studies were retrospective case series of low to intermediate quality. The penile skin inversion technique was the most frequently employed method (in 85% of the 3166 patients). The prevalence of
prolapse ranged from 0% to 7% with the penile skin inversion technique and from 1.6% to 22.7% with intestinal vaginoplasty. Upon consolidating the results, an overall rate of 2.7% was observed. Specifically, the prolapse rate within the penile inversion technique subgroup was 2.5%, while the rate for the intestinal-derived neovagina subgroup was 3.5%. The only significant risk factor identified was a high body mass index at the time of surgery. The most employed intraoperative technique to prevent neovaginal prolapse involves fixation to the sacrospinous ligament, coupled with systematic vaginal packing. Few case reports addressed the surgical treatment of neovaginal prolapse, predominantly using open abdominal or laparoscopic approaches. None of these considered transvaginal or perineal approaches. No recommendation exists about the use of vaginal prosthesis.
UNASSIGNED: Neovaginal prolapse in male-to-female transgender patients remains a rare complication, but its significance is growing as the transgender population ages. Scarce information is available regarding preventative techniques and treatments, necessitating further exploration, hampered by its infrequent occurrence.
UNASSIGNED: Neovaginal prolapse in male-to-female transgender patients is a rare complication, with the only recognized risk factor being a high body mass index. However, its importance is growing with the aging of the transgender population. Long-term complications, preventive techniques, and management of these prolapses need to be explored through further research.