Modified preparation technique of the neurovascular bundle in male to female gender confirming surgery

Main objective of gender confirming surgery (GCS) in male to female (MtF) transgender people is to create a functional and aesthetic vagino-clitoral complex. [ view full abstract ]

Main objective of gender confirming surgery (GCS) in male to female (MtF) transgender people is to create a functional and aesthetic vagino-clitoral complex.

Here we report on a modified preparation of the neurovascular bundle (NVB). Furthermore we present our data on a semiquantative score testing clitoral sensitivity in the early postoperative period as a predictive tool for the... [ view full abstract ]

Here we report on a modified preparation of the neurovascular bundle (NVB). Furthermore we present our data on a semiquantative score testing clitoral sensitivity in the early postoperative period as a predictive tool for the ability to achieve orgasms intermediate-term.

Between May 2011 and September 2014 96 consecutive MtF transgender patients underwent GCS at our department. Sensitivity of the clitoris was surveyed and medical records were browsed for documentation. Correlation analysis was... [ view full abstract ]

Between May 2011 and September 2014 96 consecutive MtF transgender patients underwent GCS at our department. Sensitivity of the clitoris was surveyed and medical records were browsed for documentation. Correlation analysis was done by Spearman Rho test. Results were compared with a historical cohort from our department (2004 - 2010, n = 119) in which perioperative treatment was the same except of the preparation of the NVB.

Sensitivity of the clitoris was assessed using a customary brush for superficial tactile sensitivity and a tuning fork according to Mattes Rydel-Seifer to quantify pallaesthesia. A semiquantitative score (no - impaired - full... [ view full abstract ]

Sensitivity of the clitoris was assessed using a customary brush for superficial tactile sensitivity and a tuning fork according to Mattes Rydel-Seifer to quantify pallaesthesia. A semiquantitative score (no - impaired - full sensitivity) was build.

In 92 (95.8%) and 78 (81.2%) patients information on neoclitoral sensitivity was available and in 79 (82.3%) and 69 (71.9%) sensitivity was tested semiquantatively after first and second stage procedure respectively. The... [ view full abstract ]

In 92 (95.8%) and 78 (81.2%) patients information on neoclitoral sensitivity was available and in 79 (82.3%) and 69 (71.9%) sensitivity was tested semiquantatively after first and second stage procedure respectively. The semiquantitative grading system correlated significantly with intermediate-term ability to achieve orgasms (p=0.036). The modification led to a reduction in operating time by averaged 61 minutes. In total we experienced a comparable rate of specific complications compared to our previous cohort with a higher rate of postoperative local hematoma but with no need for further intervention.

Preparation of the NVB with the modified technique is safe and time-saving both preserving the neoclitoral sensitivity and promoting a preferably feminine aspect of the mons pubis. Semiquantitative testing of sensitivity... [ view full abstract ]

Preparation of the NVB with the modified technique is safe and time-saving both preserving the neoclitoral sensitivity and promoting a preferably feminine aspect of the mons pubis. Semiquantitative testing of sensitivity correlates significantly with intermediate-term capability of achieving orgasms.