María B Alonso-Bartolomé, Fernández Esaú, Rodríguez Andrea, Alonso-Bartolomé Santiago, Toribio-Vázquez Carlos

(190) URETHRAL RECONSTRUCTIVE SURGERY IN TRANSGENDER PATIENTS UNDERGOING PHALLOPLASTY: A CASE REPORT

  • Urology
  • Reproductive Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Psychiatry and Mental health
Save to CiteDrive Show PDF

Abstract Objectives Transgender patients are those whose sexual identity differs from the anatomical sex with which they were born. More and more patients are looking for medical and surgical treatment to achieve the desired sex. These surgeries may have some urethral complications that urologists must be aware of and be able to treat them. The aim of this study is to present the case of a patient with several urethral complications after phalloplasty surgery. Methods Phalloplasty consists of removing the female genital tract and creating neo-male genitalia with autologous grafts. In our center, phalloplasty is performed using a radial forearm microsurgical free-flap with double tunneling, in two stages. The resulting urethra consists of a pars fixa, obtained from the tubulization of the labia minora, and a pars pendulans, formed by tubulized forearm skin. The most common urethral complications are urethrocutaneous leaks and fistulas (15-70%), especially in the two anastomotic areas; the persistence of the vaginal cavity; and urethral strictures (up to 41%). Most of these complications can be resolved conservatively or surgically. Results We present the case of a trans male who, after the first stage of phalloplasty, developed a pars fixa fistula, successfully managed conservatively. After its resolution, the second time was performed with a radial forearm microsurgical free-flap. In the immediate postoperative period, the patient required several reinterventions due to flap congestion. He developed a fistula and stricture in the new urethral anastomosis, requiring a two-stage urethroplasty with a dorsal buccal mucosa graft. After this procedure, urethral integrity was achieved with spontaneous micturition through the phallus. Conclusions Phalloplasty must be carried out by a multidisciplinary team that involves plastic and urology services. It is an increasingly frequent surgery, so mastery of the anatomy of these reconstructions by the urologist is essential to solve any complications. Conflicts of Interest No.

Need a simple solution for managing your BibTeX entries? Explore CiteDrive!

  • Web-based, modern reference management
  • Collaborate and share with fellow researchers
  • Integration with Overleaf
  • Comprehensive BibTeX/BibLaTeX support
  • Save articles and websites directly from your browser
  • Search for new articles from a database of tens of millions of references
Try out CiteDrive

More from our Archive