title: Patient-Reported Esthetic and Functional Outcomes of Primary Total Laparoscopic Intestinal Vaginoplasty in Transgender Women With Penoscrotal Hypoplasia.
abstract: Puberty-suppressing hormonal treatment may result in penoscrotal hypoplasia in transgender women, making standard penile inversion vaginoplasty not feasible. For these patients, intestinal vaginoplasty is a surgical alternative, but knowledge on patient-reported postoperative outcomes and quality of life is lacking.
  
  
  
  To assess patient-reported functional and esthetic outcomes, quality of life, satisfaction, and sexual well-being after primary total laparoscopic intestinal vaginoplasty in transgender women.
  
  
  
  A survey study was performed on transgender women who underwent primary total laparoscopic intestinal vaginoplasty with at least 1 year of clinical follow-up. Thirty-one transgender women completed the questionnaires (median age at time of surgery = 19.1 years, range = 18.3-45.0) after a median clinical follow-up of 2.2 years (range = 0.8-7.5). Consenting women were asked to complete a combined questionnaire of the Subjective Happiness Scale, the Satisfaction With Life Scale, Cantril's Ladder of Life Scale, the Female Sexual Function Index, the Female Genital Self-Imaging Scale, the Amsterdam Hyperactive Pelvic Floor Scale-Women, and a questionnaire addressing postoperative satisfaction.
  
  
  
  Patient-reported functional and esthetic outcomes and postoperative quality of life.
  
  
  
  Patients graded their life satisfaction a median of 8.0 (range = 4.0-10.0) on Cantril's Ladder of Life Scale. Patients scored a mean total score of 27.7 ± 5.8 on the Satisfaction With Life Scale, which indicated high satisfaction with life, and a mean total score of 5.6 ± 1.4 on the Subjective Happiness Scale. Functionality was graded a median score of 8.0 of 10 (range = 1.0-10.0) and esthetics a score of 8.0 out of 10 (range = 3.0-10.0). The mean Female Sexual Function Index total score of sexually active transgender women was 26.0 ± 6.8.
  
  
  
  This group of relatively young transgender women reported satisfactory functional and esthetic results of the neovagina and a good quality of life, despite low Female Sexual Function Index scores.
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Centre, Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands; Centre of Expertise on Gender Dysphoria, VU University Medical Centre, Amsterdam, The Netherlands; Gender Surgery Amsterdam, Amsterdam, The Netherlands. Electronic address: Mark-Bram.Bouman@vumc.nl.
authors.forename: Mark-Bram
authors.initials: MB
authors.lastname: Bouman
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Centre, Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Wouter B
authors.initials: WB
authors.lastname: van der Sluis
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Leonora E
authors.initials: LE
authors.lastname: van Woudenberg Hamstra
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Centre, Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands; Centre of Expertise on Gender Dysphoria, VU University Medical Centre, Amsterdam, The Netherlands; Gender Surgery Amsterdam, Amsterdam, The Netherlands.
authors.forename: Marlon E
authors.initials: ME
authors.lastname: Buncamper
authors.affiliation: EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands; Centre of Expertise on Gender Dysphoria, VU University Medical Centre, Amsterdam, The Netherlands; Department of Medical Psychology, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Baudewijntje P C
authors.initials: BPC
authors.lastname: Kreukels
authors.affiliation: EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands; Centre of Expertise on Gender Dysphoria, VU University Medical Centre, Amsterdam, The Netherlands; Gender Surgery Amsterdam, Amsterdam, The Netherlands; Department of Gastro-Intestinal Surgery and Advanced Laparoscopy, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Wilhelmus J H J
authors.initials: WJHJ
authors.lastname: Meijerink
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, VU University Medical Centre, Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands; Centre of Expertise on Gender Dysphoria, VU University Medical Centre, Amsterdam, The Netherlands.
authors.forename: Margriet G
authors.initials: MG
authors.lastname: Mullender
mesh_terms: D000328:Adult; D004954:Esthetics; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D008297:Male; D010413:Penis / Q000601:surgery*; D010502:Perineum / Q000601:surgery; D011788:Quality of Life; D057830:Gender-Affirming Surgery / Q000523:psychology*; D011795:Surveys and Questionnaires; D063106:Transgender Persons / Q000523:psychology*; D014621:Vagina / Q000601:surgery; D055815:Young Adult
keywords: Gender Dysphoria; Intestinal Vaginoplasty; Patient-Reported Outcome; Sex Reassignment Procedures; Sexual Function; Vaginoplasty