8866 Vaginoplasty Using Lyophilized Nile Tilapia Fish Skin in Sex Reassignment Surgery in 35 Transgender Women

Abstract

<h3>Study Objective</h3> describe the use of LNTFS (Lyophilized Nile Tilapia Fish Skin) as graft for the lining of the neovaginal canal in neovaginoplasty for transgender women. <h3>Design</h3> Transversal study from August 2019 to December 2020. <h3>Setting</h3> N/A. <h3>Patients or Participants</h3> 35 transgender women older than 18 years. <h3>Interventions</h3> First of all, a bilateral orchiectomy followed by ventrally urethra opening, creating a new urethral meatus and a mucosal flap that will be attached to the base of the clitoris. For the vaginal lining, a xenograft tube composed of penile skin plus LNTFS was previously constructed with the aid of a rigid mold. <h3>Measurements and Main Results</h3> Complications: 8 Introits small wound dehiscences, 3 vaginal shrinking, 1 rectal injury, 1 postoperative bleeding. Biopsies were performed 4 to 6 months after the procedure: sections of mucosa lined with non-keratinized stratified squamous epithelium, with dense fibrous connective tissue permeated by vascular neoformation. The depth and width of each neovagina ranged from 16 to 20 cm (average of 18.49 cm) and width ranges of 5 to 6 cm (average 5.8 cm). All the patients reported, after postoperative evaluation, excellent sensitivity outcomes and good aesthetic results, with the satisfactory appearance of the previously desired female genitalia, a good to an excellent self-lubricated vagina, sufficient for sexual intercourse. Indeed, sensitivity was self-reported as excellent and all of the patients had orgasms either with self-masturbations or penetration on an average of 6.14 weeks after postoperative evaluation, excellent sensitivity outcomes and good aesthetic results, with the satisfactory appearance of the previously desired female genitalia, a good to an excellent self-lubricated vagina, sufficient for sexual intercourse. Indeed, Sensitivity was self-reported as excellent and all of the patients had orgasms either with self-masturbations or penetration on an average of 6.14 weeks after surgery. <h3>Conclusion</h3> LNTFS is a biocompatible material that offers a good vaginal depth and also a moist, smooth, and self-lubricated vaginal canal.