title: Gender reassignment surgery--a 13 year review of surgical outcomes.
abstract: OBJECTIVE
  The aim of this study is to thoroughly report on surgical outcomes from 332 patients who underwent male to female gender reassignment surgery (GRS).
  
  
  METHODS
  Records from 332 patients who underwent GRS from 1995 to 2008 were reviewed. All patients were submitted to penile inversion vaginoplasty with glans-derived sensate clitoroplasty. Mean age was 36.7 years (range 19-68 years). Surgical complications were stratified in 5 main groups: genital region, urinary tract, gastrointestinal events, wound healing disorders and unspecific events.
  
  
  RESULTS
  Progressive obstructive voiding disorder due to meatal stenosis was the main complication observed in 40% of the patients, feasibly corrected during the second setting. Stricture recurrence was found in 15%. Stricture of vaginal introitus was observed in 15% of the cases followed by 12% and 8% of vaginal stenosis and lost of vaginal depth, respectively. Rectal injury was seen in 3% and minor wound healing disorders in 33% of the subjects.
  
  
  CONCLUSIONS
  Regarding male to female GRS, a review of the current literature demonstrated scarce description of complications and their treatment options. These findings motivated a review of our surgical outcomes. Results showed a great number of adverse events, although functionality preserved. Comparision of our outcomes with recent publications additionally showed that treatment options provide satisfying results. Moreover, outcomes reaffirm penile inversion vaginoplasty in combination with glans-derived sensate clitoroplasty as a safe technique. Nevertheless, discussing and improving surgical techniques in order to reduce complications and their influence on patient's quality of life is still strongly necessary and theme of our future reports.
authors.affiliation: Department of Urology, University of Essen Medical School, Essen, Germany. roberto.rossineto@uk-essen.de
authors.forename: R
authors.initials: R
authors.lastname: Rossi Neto
authors.forename: F
authors.initials: F
authors.lastname: Hintz
authors.forename: S
authors.initials: S
authors.lastname: Krege
authors.forename: H
authors.initials: H
authors.lastname: Rubben
authors.forename: F
authors.initials: F
authors.lastname: Vom Dorp
mesh_terms: D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D005837:Genitalia, Male / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D057830:Gender-Affirming Surgery / Q000379:methods* / Q000706:statistics & numerical data; D014189:Transsexualism / Q000601:surgery*; D055815:Young Adult