Abstract
Abstract Background: Prolapse of the neovagina is a rarely reported complication of male-to-female transgender surgery and is not commonly encountered by gynecologists. Documented management of such cases is scarce in the literature and includes a few case reports or abstracts. This article reports the current authors' experience treating complete eversion of the neovagina successfully with laparoscopic sacrocolpopexy. Case: A 55-year-old transgender female had complete eversion of her neovagina and symptoms of obstructive defecation syndrome (ODS). Use of a ring pessary was unsuccessful. A magnetic resonance imaging proctogram revealed anismus, and paradoxical contraction of the anal canal and puborectalis muscle. At a pelvic-floor multidisciplinary meeting, biofeedback treatment was recommended for her ODS symptoms as well as laparoscopic sacrocolpopexy. The procedure posed various technical difficulties for this patient, compared to an XX female, including lack of a distinct rectovaginal septum, a narr...
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