Our Summary

This research paper evaluates the effectiveness and safety of removing the uterus (hysterectomy) using a surgical robot in transgender men or people who don’t conform to the traditional gender binary (male/female). The study was conducted from February 2016 to January 2018 and included 20 transgender patients diagnosed with gender dysphoria who had no genital diseases. The surgeries were performed using a robot named Da Vinci Xi.

The results showed that there were no complications during or after the surgery. The procedure took about 90 minutes on average, including setup time, with a total time in the operating room averaging 140 minutes. The average blood loss was around 90 ml, leading to an approximately 8% decrease in hemoglobin levels (a protein in red blood cells that carries oxygen). The pain after surgery was relatively low, with scores of 3 and 2 out of 10, on the first and second days after surgery, respectively.

The study found no signs of cancer in the surgically removed tissue. The results suggest that using robotic surgery for hysterectomies in transgender men or gender non-conforming individuals is a feasible, safe, and effective option. The study’s focus was on gender-affirming surgery, hysterectomy, robotic surgery, and the transgender and gender-nonconforming population.

FAQs

  1. What was the aim of the research study conducted between February 2016 and January 2018?
  2. What were the results of the robotic hysterectomy procedures performed on the transgender patients in the study?
  3. Is robotic surgery for hysterectomies in transgender men or gender non-conforming individuals considered safe and effective according to the study?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hysterectomy is to discuss the potential risks and benefits of the procedure thoroughly before making a decision. It’s important to ask questions, voice any concerns, and understand what to expect during and after the surgery. Additionally, following post-operative instructions, such as taking prescribed medications, attending follow-up appointments, and allowing for proper rest and recovery, can help ensure a successful outcome.

Suitable For

Patients who may be recommended for a hysterectomy include those with:

  1. Uterine fibroids: Noncancerous growths in the uterus that can cause heavy menstrual bleeding, pelvic pain, and pressure on the bladder or rectum.

  2. Endometriosis: A condition in which the tissue that normally lines the inside of the uterus grows outside of it, leading to painful periods, infertility, and other symptoms.

  3. Adenomyosis: A condition in which the tissue that lines the uterus grows into the muscular wall of the uterus, causing heavy menstrual bleeding, severe cramping, and pelvic pain.

  4. Uterine prolapse: A condition in which the uterus slips down into or protrudes out of the vagina, often due to weakened pelvic muscles.

  5. Gynecologic cancers: Hysterectomy may be recommended as part of the treatment for uterine, cervical, or ovarian cancer.

  6. Chronic pelvic pain: Hysterectomy may be considered for patients with severe and debilitating pelvic pain that does not respond to other treatments.

  7. Transgender men or individuals who do not conform to the traditional gender binary: Hysterectomy may be part of gender-affirming surgery for transgender men or non-binary individuals who desire to align their physical body with their gender identity.

It is important for patients to discuss their individual circumstances and medical history with their healthcare provider to determine if a hysterectomy is the best course of treatment for them.

Timeline

Before the hysterectomy:

  • Patient meets with a healthcare provider to discuss the reasons for the hysterectomy and any alternative treatments
  • Patient undergoes pre-operative testing and evaluations, such as blood tests and imaging studies
  • Patient may need to make lifestyle changes or take medications leading up to the surgery
  • Patient may experience anxiety or uncertainty about the surgery and its potential effects on their body

After the hysterectomy:

  • Patient stays in the hospital for a few days to recover from the surgery
  • Patient may experience pain, fatigue, and discomfort in the days following the surgery
  • Patient may need to take pain medications and follow a specific diet to aid in recovery
  • Patient may need to refrain from certain activities and exercise for a period of time
  • Patient may experience emotions such as relief, sadness, or a sense of loss after undergoing the procedure

Overall, the timeline of a patient’s experience before and after a hysterectomy can vary depending on individual circumstances and the type of hysterectomy performed. It is important for patients to discuss any concerns or questions with their healthcare provider before and after the surgery.

What to Ask Your Doctor

  1. What are the reasons for recommending a hysterectomy in my case?
  2. Are there any alternative treatments or procedures that could be considered instead of a hysterectomy?
  3. What are the potential risks and complications associated with a hysterectomy?
  4. What is the expected recovery time and post-operative care following a hysterectomy?
  5. Will a hysterectomy affect my hormone levels or overall health in any way?
  6. How will a hysterectomy impact my fertility and options for future family planning?
  7. What type of hysterectomy procedure will be performed (laparoscopic, robotic, abdominal, etc.) and why?
  8. How many hysterectomies have you performed using robotic surgery, and what is your experience with this approach?
  9. What are the long-term effects or considerations I should be aware of after having a hysterectomy?
  10. Are there any specific guidelines or recommendations for transgender individuals undergoing a hysterectomy, such as hormone therapy adjustments or follow-up care?

Reference

Authors: Giampaolino P, Della Corte L, Improda FP, Perna L, Granata M, Di Spiezio Sardo A, Bifulco G. Journal: J Invest Surg. 2021 Jun;34(6):645-650. doi: 10.1080/08941939.2019.1669744. Epub 2019 Oct 6. PMID: 31588839