You have accessJournal of UrologyCME1 Apr 2023MP02-14 PREDICTORS OF SURGICAL RISK AND OUTCOMES OF GENDER AFFIRMING SURGERY Rishabh Simhal, Kerith Wang, Yash Shah, and Paul Chung Rishabh SimhalRishabh Simhal More articles by this author , Kerith WangKerith Wang More articles by this author , Yash ShahYash Shah More articles by this author , and Paul ChungPaul Chung More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003213.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Dramatic advances have occurred in phalloplasty (PLP) and vaginoplasty (VGP) for gender dysphoria. However, there is need for better characterization of patient demographics and surgical outcomes to aid in patient selection, counseling, and quality improvement. METHODS: PLPs and VGPs performed from 2006-2020 were identified in National Surgical Quality Improvement Program (NSQIP) database. Major (e.g. reintubation, septic shock, etc.) and minor complications (e.g. urinary tract infection, superficial wound infection, etc.) were categorized by NSQIP. Frailty was based on the modified frailty index (NSQIP-mFI-5), a validated score including points for diabetes, functional status, obstructive pulmonary disease, heart failure, and hypertension. Pre-operative(op) morbidity probabilities were derived from the NSQIP morbidity probability, which uses hierarchical regression analysis on patient-specific factors. RESULTS: 58 PLPs and 485 VGPs were identified. The mean patient age was 38.4±11.8 years for PLP and 36.6±12.6 for VGP. The average op time for PLP and VGP was 331 and 263 minutes, and the average LOS was 5.1 days and 4.3 days, respectively. The overall 30-day complication rate for PLP was 26%, with 17% of total patients experiencing minor complications and 16% experiencing major complications. The overall, minor, and major complications rates for VGP were 14%, 7%, and 9%. Readmissions and reoperations occurred in 7% PLP and 5% VGP patients. No deaths occurred in either group within 30 days.NSQIP-mFI-5 scores ≥0.2 versus a score of 0 were not predictive of 30-day complications, op time, or LOS for either procedure. For VGPs, higher NSQIP-mFI-5 scores were numerically associated with higher complication rates (OR 2.02, 95% CI 0.94-4.09, p=0.072). When comparing NSQIP morbidity probabilities of ≥10% vs <10%, this score was predictive of 30-day complications for both PLP (OR 4.0, 95% CI 1.1-19.6, p=0.038) and VGP (OR 2.46, 95% CI 1.4-4.3, p<0.001). NSQIP morbidity probability ≥10% was also predictive of extended LOS for PLP patients (6.3±1.3 vs 2.9±0.8, p=0.03). CONCLUSIONS: This study described the patient characteristics and complication rates of PLP and VGP. The NSQIP preop morbidity probability is an effective predictor of surgical complications and is a better predictor than the NSQIP-mFI-5. Source of Funding: n/a © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e16 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rishabh Simhal More articles by this author Kerith Wang More articles by this author Yash Shah More articles by this author Paul Chung More articles by this author Expand All Advertisement PDF downloadLoading ...