A Novel Technique of Urethroplasty Could Reduce Urethra-Related Complications in Phalloplasty With Urethral Lengthening

作者：Hong Gao, Dan Wu, Xiang‐Jing Kong, Lie Zhu, Xiang Jie, Wenjun Zhang, Zheyuan Hu, Xiaohai Zhu · 发表于：Sexual Medicine · 年份：2022 · DOI：10.1016/j.esxm.2022.100571 · 被引用次数：6 · 研究领域：Reconstructive Surgery and Microvascular Techniques、Urological Disorders and Treatments、Sexual function and dysfunction studies

INTRODUCTION: Urethral lengthening in phalloplasty could bring many postoperative complications, such as urethra fistula and stricture, which greatly affects the patient's mental health and quality of life. AIM: To describe a novel technique of vaginal mucosal graft for prelamination urethra (VMGPU) combined with modified urethral anastomosis (MUA) for the reconstruction of a neourethra. METHODS: A retrospective study of transgender men between January 2006 and March 2021 was conducted. Patients were divided into three groups according to the surgical methods : traditional group（TG，VMGPU group（VG） and VMGPU+MUA group (VMG). MAIN OUTCOME MEASURE: The main outcomes measures were demographics, surgical characteristics, complications, International Prostate Symptom Score（IPSS，Quality of Life（QOL） score，and voiding frequency conditions. RESULTS: Of 80 eligible transgender men（TG:n = 39，VG:n = 31, VMG:n = 10), the urethral fistula developed in 19/39 (49%) patients in TG, 8/31 (26%) in VG, and 1/10 (10%) in VMG (P = 0.034). The urethral stricture formed in 15/39 (38%) patients in TG, 4/31 (13%) in VG, and 1/10 (10%) in VMG (P = 0.028). Compared with TG, the VG got more favorable IPSS. The QOL scores showed that patients in VG or VMG were more satisfied with their postoperative status. CLINICAL IMPLICATIONS: VMGPU combined with MUA may help reduce urethral complications for transgender men who wish to undergo phalloplasty with urethral lengthening. STRENGTH & LIMITATIONS: VMGPU combi...