Gynaecological surgery techniques in female to male transsexualism.
Authors:
R. Hudeček; J. Navrátilová; R. Krajčovičová
Authors place of work:
LF MU a FN Brno
; Gynekologicko-porodnická klinika
Published in the journal:
Prakt Gyn 2010; 14(2): 71-75
Category:
Review Article
Summary
Gynaecological surgery techniques in female to male transsexualism.
Aim:
To evaluate clinical data gathered over 14 years on gynaecological surgery techniques used for female to male transsexualism from the perspective of surgery invasiveness, technical demands, length of the surgery and duration of hospitalization and incidence of peri-operative and post-operative complications.
Materials:
115 transsexual female to male women with 46 XX caryotype with normal gynaecological finding (95% virgo intacta) undergoing the surgery between 1996–2009 following at least 12 months of hormonal preparation (Agovirin, Sustanon).
Methods:
The following techniques were used for corrective surgery to perform hysterectomy with bilateral adnexectomy and, alternatively colpectomy: Abdominal hysterectomy with bilateral adnexectomy (HA + AE), abdominal hysterectomy with bilateral adnexectomy with colpectomy (HA + AE + C), vaginal intrafascial hysterectomy with bilateral adnexectomy (HV + AE), laparoscopy-assisted vaginal intrafascial hysterectomy with bilateral adnexectomy (LAVH + AE), vaginal intrafascial hysterectomy with laparoscopic colpectomy with bilateral adnexectomy (LAVH-LC + AE).
Results:
The following surgeries were performed on the evaluated patient sample: 53 HA + AE surgeries (46.1 %), 7 HA + AE + K surgeries (6.1 %), 25 HV + AE surgeries (21.7 %), 27 LAVH + AE surgeries (23.4 %) and 3 LAVH-LC + AE surgeries (2.6 %). The mean duration of the surgery (min) was 70 min in the 53 HA + AE surgeries, 100 min in the 7 HA + AE + K surgeries, 80 min in the 25 HV + AE surgeries, 60 min in the 27 LAVH + AE surgeries and 80 min in the 3 LAVH-LC + AE surgeries. The mean loss of blood post-surgery (ml) was 250 ml in the 53 HA + AE surgeries, 300 ml in the 7 HA + AE + K surgeries, 200 ml in the 25 HV + AE surgeries, 150 ml in the 27 LAVH + AE surgeries and 150 ml in the 3 LAVH-LC + AE surgeries. Post-surgery complications occurred in 1 case (0.9%) in the evaluated sample (n=115). The mean duration of hospitalization (days) was 6 days in the 53 HA + AE surgeries, 8 days in the 7 HA + AE + K surgeries, 7 days in the 25 HV + AE surgeries, 5 days in the 27 LAVH + AE surgeries and 5 days in the 3 LAVH-LC + AE surgeries.
Conclusion:
Our data suggest that laparoscopic vaginal hysterectomy with bilateral adnexectomy is the most suitable approach to surgical management of female to male transsexualism. When used in routine clinical practice (N=27, 23.4%) this method was associated with the shortest duration of the surgery (60 min), the lowest post-surgery blood loss (150 ml), the shortest mean duration of hospitalization (5 days) and acceptable incidence of post-surgery complications (0.9%). The importance of LAHV-LC + AE and total laparoscopic hysterectomy with bilateral adnexectomy is likely to grow in the future.
Key words:
female to male transsexualism – hysterectomy with adnexectomy
Zdroje
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Štítky
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicineČlánok vyšiel v časopise
Practical Gynecology
2010 Číslo 2
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