Official websites use. Share sensitive information only on official, secure websites. Corresponding author. Neovaginal prolapse remains an infrequent complication of vaginoplasty in transgender patients, with an average rate of 2. One recognized risk factor is a high body mass index. No specific perioperative technique can be recommended.
Addressing the long-term complications of gender-affirming surgeries is an up-and-coming topic. Most trans women are requesting a gender affirming genital surgery by vulvovaginoplasty. However, long-term complications such as genital prolapse are unknown.
Through this systematic review, our objective was to provide an overview of the published outcomes related to genital prolapse after vaginoplasty in male-to-female transgender individuals, including prevalence, identified risk factors, and treatment. We included all studies reporting genital prolapse rates following vulvovaginoplasty from to the present. Only studies that focused on the transgender population were included. The primary outcome was the genital prolapse rate.
The secondary outcomes included risk factors and treatment of genital prolapse after vulvovaginoplasty. Article selection was performed by two independent reviewers. Twenty-four studies, involving patients, that presented sufficient data were analyzed. The mean age at the time of vulvovaginoplasty was The mean follow-up time was Most of the studies were retrospective case series of low to intermediate quality. Upon consolidating the results, an overall rate of 2.
Specifically, the prolapse rate within the penile inversion technique subgroup was 2. The only significant risk factor identified was a high body mass index at the time of surgery. The most employed intraoperative technique to prevent neovaginal prolapse involves fixation to the sacrospinous ligament, coupled with systematic vaginal packing. Few case reports addressed the surgical treatment of neovaginal prolapse, predominantly using open abdominal or laparoscopic approaches.
