ArticleInternational journal of impotence research2025
Management of cosmetic concerns after gender-affirming vaginoplasty: a retrospective case series and guide to revisions.
Article in International journal of impotence research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
This retrospective study examines 58 transgender women who presented with cosmetic concerns following gender-affirming vaginoplasty between January 2020 and April 2023. The cohort's mean age was 36.8 years (±9.8), with a mean BMI of 29.5 kg/m² (±7.1). Most patients were Black or African American (41.4%) or White (31.4%), and 43.0% had wound healing comorbidities. Of the total cohort, 62.1% (36/58) underwent penile inversion vaginoplasty (PIV), 31.0% (18/58) robotic-assisted vaginoplasty with peritoneal flaps, and 6.9% (4/58) shallow-depth vaginoplasty. A total of 36.2% (21/58) patients reported cosmetic concerns, most frequently labial (20.7%), clitoral (12.1%), hypergranulation tissue (8.6%), mons pubis fullness (5.2%), and introital scarring (5.2%). Management included expectant care, in-office procedures (e.g., silver nitrate for hypergranulation), and surgical revision. Surgical revision was performed in 80.9% of patients, with all reporting post-operative cosmetic satisfaction. A guide to surgical revision is discussed for each cosmetic concern subgroup. A tiered approach involving expectant management, in-office interventions, and surgical revision can effectively address these issues and enhance patient satisfaction.
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