title: Total laparoscopic intestinal vaginoplasty as neovaginal reconstruction in an HIV-positive transgender woman.
abstract: A 46-year-old, HIV-positive transgender woman of South American ethnicity consulted our outpatient clinic to discuss the possibilities of a surgical, secondary neovaginal reconstruction because of complete stenosis of her inverted penile skin-lined neovagina. She was taking abacavir/lamivudine and nevirapine as antiretroviral therapy. We successfully performed a total laparoscopic sigmoid vaginoplasty without any complications. There was no short-term morbidity and no complications were reported after 15 months of follow-up. To our knowledge, this is the first report of laparoscopic sigmoid vaginoplasty as vaginal reconstruction in a HIV-positive transgender woman. Worldwide, transgender women have a high burden of HIV infection. This report shows that intestinal vaginoplasty is a feasible surgical option for HIV-positive transgender women in need of vaginal reconstruction. Because patients are again able to engage in penetrative sexual intercourse, we emphasise the importance of practicing safe sex and early initiation of adequate antiretroviral therapy in this patient population.
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, the Netherlands w.vandersluis@vumc.nl.
authors.forename: Wouter B
authors.initials: WB
authors.lastname: van der Sluis
authors.affiliation: Laboratory of Immunogenetics, Department of Medical Microbiology and Infection Control, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: Stephan P
authors.initials: SP
authors.lastname: Verweij
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, the Netherlands Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: Mujde
authors.initials: M
authors.lastname: Özer
authors.affiliation: Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, the Netherlands Department of Gastro-intestinal Surgery and Advanced Laparoscopy, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: Wilhelmus J
authors.initials: WJ
authors.lastname: Meijerink
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Center, Amsterdam, the Netherlands Center of Expertise on Gender Dysphoria, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: Mark-Bram
authors.initials: MB
authors.lastname: Bouman
mesh_terms: D012809:Colon, Sigmoid / Q000637:transplantation*; D005260:Female; D006679:HIV Seropositivity; D006801:Humans; D010535:Laparoscopy; D008297:Male; D010413:Penis / Q000473:pathology / Q000601:surgery*; D010502:Perineum / Q000503:physiopathology / Q000601:surgery*; D012611:Scrotum / Q000473:pathology / Q000601:surgery*; D057830:Gender-Affirming Surgery / Q000379:methods*; D063106:Transgender Persons; D014189:Transsexualism / Q000601:surgery; D016896:Treatment Outcome; D014621:Vagina / Q000601:surgery*
keywords: AIDS; HIV; gender surgery; intestinal neovagina; male-to-female transsexuality; sex reassignment surgery; sexual behaviour; surgery; transgender