V04-11 COMBINATION OF ROBOTIC-ASSISTED LAPAROSCOPIC PEDICLED PERITONEAL FLAP VAGINOPLASTY WITH PENILE SKIN INVERSION TECHNIQUE IN MALE-TO-FEMALE TRANSGENDER SURGERY. INSTRUCTIVE VIDEO-ARTICLE

Abstract

You have accessJournal of UrologyCME1 May 2022V04-11 COMBINATION OF ROBOTIC-ASSISTED LAPAROSCOPIC PEDICLED PERITONEAL FLAP VAGINOPLASTY WITH PENILE SKIN INVERSION TECHNIQUE IN MALE-TO-FEMALE TRANSGENDER SURGERY. INSTRUCTIVE VIDEO-ARTICLE Eusebio Luna, Sidhbh Gallagher, Edward Gheiler, Ariel Kaufman, Luanda Perez, Dailianys Barrios, Melanie Milanes, and Fernando Bianco Eusebio LunaEusebio Luna More articles by this author , Sidhbh GallagherSidhbh Gallagher More articles by this author , Edward GheilerEdward Gheiler More articles by this author , Ariel KaufmanAriel Kaufman More articles by this author , Luanda PerezLuanda Perez More articles by this author , Dailianys BarriosDailianys Barrios More articles by this author , Melanie MilanesMelanie Milanes More articles by this author , and Fernando BiancoFernando Bianco More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002560.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Gender-Affirming vaginoplasty comprises vulvar and vaginal canal creation.1 Those procedures can be considered separately, and we focus our video-article on vaginal canal construction. In male-to-female transgender surgery, penile skin inversion to line the neovagina is considered the gold standard procedure.2 In our experience, the combination of this technique with The Davydov procedure, commonly used for vaginoplasty in female patients with Mayer-Rokitansky-Kuster-Hauser-Syndrome (MRKH) 3 grants an excellent depth of the vaginal canal, and great comfort to the patient during vaginal intercourse. METHODS: This video abstract features the vaginal canal creation in a 33-year-old male with a long-standing history of gender dysphoria. The intervention starts with the peritoneal walls harvesting at the level of Douglas Pouch, to create a vascular pedicled peritoneal flap. Next, a careful robotic perineal body dissection allowed us establishing external communication of the neovaginal canal. Afterward, the robotic-assisted anastomosis between the previously dissected inverted penile skin and the peritoneal flap is carried. The vaginal cuff closure and colpopexy finish the intervention. RESULTS: Operative time was 140 minutes, blood loss 80 cc, a perineal pack, and a Foley catheter were placed after the intervention and removed on the 7th postoperative day. The patient remained hospitalized for two days. There were no reported complications other than some right labia minora epidermolysis on the 6th postoperative day which has since resolved. The vaginal dimension at the 4th postoperative month is 6 inches in depth. Periodic dilations with a 1.5 inches dilator are needed. CONCLUSIONS: The combination of robotic-assisted laparoscopic pedicled peritoneal flap vaginoplasty with penile skin inversion technique represents a feasible and reliable option for patients interested in male-to-female transgender surgery. Source of Funding: none © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e370 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Eusebio Luna More articles by this author Sidhbh Gallagher More articles by this author Edward Gheiler More articles by this author Ariel Kaufman More articles by this author Luanda Perez More articles by this author Dailianys Barrios More articles by this author Melanie Milanes More articles by this author Fernando Bianco More articles by this author Expand All Advertisement PDF DownloadLoading ...