title: Neovaginal prolapse in male-to-female transsexuals: an 18-year-long experience.
abstract: Neovaginal prolapse is a rare and distressing complication after male-to-female sexual reassignment surgery. We retrospectively analysed the prevalence of partial and total neo-vaginal prolapses after sexual reassignment surgery in our institute. During the years, two different techniques have been adopted with the aim of fixing the neovaginal cylinder. In the first, two absorbable sutures are placed at the top of the penoscrotal cylinder and fixed to the Denonvilliers fascia. In the second, two additional sutures are added from the posterior/midpoint of the flap to the prerectal fascia. We enrolled 282 consecutive transsexual patients. 65 (23.04%) out of the 282 were treated with the first technique and the following 217 (76.96%) with the last technique. In the first technique, 1 case (1.53%) of total prolapse and 7 cases (10.76%) of partial prolapse were observed, while in the other 217 patients treated with the second technique only 9 cases of partial prolapse were observed (4.14%) and no cases of total prolapse. All prolapses occurred within 6 months from the procedure. In our experience, the use of 4 stitches and a more proximal positioning of the sutures to fix the penoscrotal apex with the Denonvilliers fascia guarantees a lower risk of prolapse.
authors.affiliation: Department of Urology, Cattinara Hospital, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Bucci
authors.affiliation: Department of Urology, Cattinara Hospital, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy.
authors.forename: Giorgio
authors.identifier: 0000-0002-3892-364X
authors.initials: G
authors.lastname: Mazzon
authors.affiliation: Department of Urology, Cattinara Hospital, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Liguori
authors.affiliation: Department of Urology, Cattinara Hospital, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy.
authors.forename: Renata
authors.identifier: 0000-0002-0901-1588
authors.initials: R
authors.lastname: Napoli
authors.affiliation: Department of Urology, Cattinara Hospital, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy.
authors.forename: Nicola
authors.identifier: 0000-0001-7355-7625
authors.initials: N
authors.lastname: Pavan
authors.affiliation: Department of Urology, Cattinara Hospital, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy.
authors.forename: Susanna
authors.initials: S
authors.lastname: Bormioli
authors.affiliation: Department of Urology, Cattinara Hospital, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy.
authors.forename: Giangiacomo
authors.identifier: 0000-0003-2079-6635
authors.initials: G
authors.lastname: Ollandini
authors.affiliation: Department of Urology, Cattinara Hospital, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy.
authors.forename: Bernardino
authors.initials: B
authors.lastname: De Concilio
authors.affiliation: Department of Urology, Cattinara Hospital, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Trombetta
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D057829:Gender-Affirming Procedures / Q000706:statistics & numerical data*; D057830:Gender-Affirming Surgery / Q000706:statistics & numerical data*; D013536:Suture Techniques / Q000706:statistics & numerical data*; D063106:Transgender Persons / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014596:Uterine Prolapse / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult