Surgical Micro-dissection of the posterior commissure after during vaginoplasty: Observations to explain common post-operative complications and proposed strategies for their prevention

Background

Tearing and stenosis of the posterior commissure of the neovagina are not uncommon after vaginoplasty. With the most common surgical approach for vaginoplasty, the penile inversion technique, the posterior commissure is... [ view full abstract ]

Aim(s)

We propose that a combination of anatomic features of the posterior commissure, combined with features of surgical technique, contribute to these complications. We describe anatomic findings of the tissues of the posterior... [ view full abstract ]

Main Outcome Measures

Intra-operative observations from live surgeries and post-operative findings were recorded using photography and video among transgender women undergoing vaginoplasty. Surgical micro dissection was performed using cadaveric... [ view full abstract ]

Methods

Recorded intra-operative and post-operative photographs and video Patient self-reported outcomes Histologic analysis of posterior commissure tissues (H&E, Trichrome, and others) [ view full abstract ]

Results

Intra-operatve and post-op observations suggest that dense constrictive bands of tissue exist in the base of the penile shaft skin. Anatomic micro-dissection of the these tissues reveals the presence of a dense semi-ordered... [ view full abstract ]

Conclusion

Surgical micro-dissecton of the tissues of the posterior commissure after vaginoplasty suggests that dense collagen bundles in the penile skin are at least a contributing factor (if not the principal source) to obstructive... [ view full abstract ]

Authors

Maurice Garcia (University of California San Francisco)

Topic Area

Oral & Poster Topics: Surgery

Session

PS-7 » E-Posters Surgery (3) (16:30 - Thursday, 6th April, Danube)

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