Pelvic anatomy and transgender vaginoplasty surgery: Proposed anatomy and physiologic-based considerations to guide pre-operative counseling, surgical approach, self-dilation, and douching

Background

Surgical techniques to perform vaginoplasty vary. Description of particular techniques is often limited to the "how to", but necessarily the "why"- or "why not". Answers to the latter can be especially enriching for... [ view full abstract ]

Aim(s)

1. We review the anatomic basis for a sharp surgical approach, instead of a blunt and limited sharp-dissection approach, through the terminus of Denonvillier's Fascia upon the posterior aspect of the prostate gland for access... [ view full abstract ]

Main Outcome Measures

Aim 1: A. We describe our surgical technique. B. We resected blocks of tissue that contained posterior prostate, Denonvilliers Fasica (DVF), and anterior rectum, from 5 cadavers, and performed immunohistochemistry to allow us... [ view full abstract ]

Methods

Aim 1: Cadaveric genetic male pelvis tissues subjected to immunohistochemistry after vaginoplasty surgery via penile inversion Aim 2: Imaging studies of living women and cadaveric anatomic dissections of human pelvises after... [ view full abstract ]

Results

Aim 1: Immunohistochemistry results showed that the sharp dissection we describe is associated with incision through significantly fewer blood vessels and sensory-motor nerves as compared to the traditional surgical approach.... [ view full abstract ]

Conclusion

Anatomy suggests that dissection posterior to DVF should be avoided in order to minimize risk of laceration and/or development of fistulae between the neovagina and rectum. Our findings suggest that a sharp surgical approach... [ view full abstract ]

Authors

Maurice Garcia (University of California San Francisco)

Topic Area

Oral & Poster Topics: Surgery

Session

OS-2E » Surgery II: from Beginning to the End (16:00 - Friday, 7th April, Exhibition Hall)

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