Gender Affirming Surgery: Considerations for the Urogynecologist_OnDemand-Recording_Gender Affirming Surgery: Considerations for the Urogynecologist

Video Transcription

Video Summary

The webinar, moderated by Dr. Kimmy Ohminhaji and presented by Dr. Anne Tran, focused on gender-affirming surgery and its relevance to urogynecologists. Dr. Tran, a dual board-certified urogynecologist and obstetrician-gynecologist with extensive expertise in pelvic reconstructive surgery, highlighted the increasing demand for gender-affirming surgeries such as mastectomies, hysterectomies, vaginoplasties, metoidoplasties, and phalloplasties.<br /><br />Key points included understanding patient criteria for surgery per the World Professional Association for Transgender Health (WPATH), preoperative psychological evaluation, and importance of mental health support postoperatively due to irreversible changes and potential complications. Dr. Tran detailed surgical techniques for trans-male procedures including hysterectomy, vaginectomy, metoidoplasty (creation of a neophallus from hormonally-enlarged clitoral tissue), and complex phalloplasty involving tissue flaps and microsurgery. Complications like urethral fistulas, strictures, hematomas, and implant issues were discussed with management strategies.<br /><br />For trans-female patients, Dr. Tran reviewed penile inversion vaginoplasty and newer techniques such as primary peritoneal flap vaginoplasty, along with augmentation options using intestinal flaps or grafts. She emphasized the importance of postoperative dilation to maintain vaginal canal patency and prevention of stenosis. She also noted the role of urogynecologists in managing postoperative complications and revisions, advocating for active urogynecologic involvement alongside plastic surgery and urology in this evolving field.<br /><br />Overall, Dr. Tran underscored the substantial improvements in quality of life following gender-affirming surgeries and encouraged urogynecologists to engage in research and clinical care to meet the growing needs of transgender patients.

Keywords

gender-affirming surgery

urogynecology

transgender health

WPATH criteria

pelvic reconstructive surgery

trans-male procedures

phalloplasty

vaginoplasty

postoperative care

surgical complications