Our Summary

This research paper is a review of the urinary complications that can occur after a specific type of gender-affirming surgery for transgender women called penile inversion vaginoplasty (PIV). The researchers looked at several studies to get an idea of how common these complications are.

The paper found that the most common urinary problems after this surgery include a weak or split urine stream, narrowing of the urethra (the tube that allows urine to pass out of the body), and symptoms like needing to pee often, urgently, or during the night. Other complications can include needing a catheter to help pee, leaking urine, a tight or narrow urethra, and urinary tract infections.

However, these complications are generally not very common. The researchers also found that most patients were satisfied with the results of their surgery. They suggest that there needs to be more standardization in how these surgeries are reported so that we can better understand these outcomes and improve how patients are looked after following surgery.

FAQs

  1. What are the most common urinary complications after penile inversion vaginoplasty?
  2. Are urinary complications after penile inversion vaginoplasty common?
  3. What improvements do researchers suggest regarding the reporting of penile inversion vaginoplasty surgeries?

Doctor’s Tip

One helpful tip a doctor might give a patient about vaginoplasty is to follow all post-operative care instructions carefully. This may include taking prescribed medications, avoiding strenuous activities, and attending follow-up appointments as scheduled. It is important to communicate any concerns or changes in symptoms to your healthcare provider promptly. By following these guidelines, you can help ensure a successful recovery and minimize the risk of complications.

Suitable For

Patients who are typically recommended vaginoplasty include transgender women who desire gender-affirming surgery to align their physical appearance with their gender identity. Vaginoplasty is a common surgical procedure for transgender women seeking to have a more feminine genital appearance and function. It is important for patients to undergo a thorough evaluation by a qualified healthcare provider to determine if they are suitable candidates for surgery.

In addition to transgender women, cisgender women who may require vaginoplasty include those with congenital abnormalities of the vagina, such as vaginal agenesis or vaginal atresia. These conditions can affect a person’s quality of life and may require surgical intervention to improve vaginal function and appearance.

Overall, patients recommended for vaginoplasty are those who have a strong desire for gender affirmation or those with medical conditions that necessitate surgical intervention to improve vaginal function. It is important for patients to discuss their goals and expectations with their healthcare provider to determine if vaginoplasty is the right option for them.

Timeline

Timeline of patient experiences before and after vaginoplasty:

Before surgery:

  1. Initial consultation with a gender-affirming surgeon to discuss the procedure and expectations.
  2. Pre-operative assessments and tests to ensure the patient is a suitable candidate for surgery.
  3. Psychological assessments and counseling to ensure the patient is mentally prepared for the procedure.
  4. Hormone therapy may be required to prepare the body for surgery.
  5. Patient education on the surgical procedure, recovery process, and potential risks and complications.

After surgery:

  1. Recovery period in the hospital for a few days to monitor for any post-operative complications.
  2. Follow-up appointments with the surgeon to monitor healing and address any concerns.
  3. Pain management and wound care to promote healing and reduce discomfort.
  4. Physical therapy to help with recovery and regain strength and function in the pelvic area.
  5. Psychological counseling and support to help the patient adjust to their new anatomy and navigate any emotional challenges.
  6. Long-term follow-up care to monitor for any potential complications and ensure the best possible outcomes for the patient.

Overall, the timeline for a patient before and after vaginoplasty involves thorough preparation, surgery, recovery, and ongoing support to ensure a successful and satisfying outcome.

What to Ask Your Doctor

Some questions a patient should ask their doctor about vaginoplasty include:

  1. What are the potential urinary complications that can occur after vaginoplasty?
  2. How common are these urinary complications in patients who undergo penile inversion vaginoplasty?
  3. What symptoms should I watch out for that may indicate a urinary issue after surgery?
  4. What can be done to prevent or minimize the risk of urinary complications post-surgery?
  5. How are urinary complications typically treated if they do occur?
  6. Will I need to have follow-up appointments to monitor my urinary health after surgery?
  7. Are there any lifestyle changes or precautions I should take to reduce my risk of urinary issues after vaginoplasty?
  8. How satisfied are most patients with the results of their surgery in terms of urinary function?
  9. Are there any specific factors that may increase my risk of experiencing urinary complications after vaginoplasty?
  10. Is there ongoing research or advancements in the field that may improve outcomes for patients undergoing vaginoplasty in the future?

Reference

Authors: Ding C, Khondker A, Goldenberg MG, Kwong JCC, Lajkosz K, Potter E, Millman A, Krakowsky Y, Perlis N. Journal: Can Urol Assoc J. 2023 Apr;17(4):121-128. doi: 10.5489/cuaj.8108. PMID: 36486178