Male-to-Female Gender-Affirming Surgery Using Nile Tilapia Fish Skin as a Biocompatible Graft.

Autor:	Rodríguez ÁH; Center Specialized in Breast Surgery and Transgender Surgery, Cali, Colombia (Dr. Rodríguez)., Lima Júnior EM; Burn Treatment Center, Dr. José Frota Institute, Fortaleza (Mr. Lima Júnior)., de Moraes Filho MO; Clinical Pharmacology Unit, Drug Research and Development Center (Drs. de Moraes Filho, Costa, Amaral de Moraes, Rodrigues, and Paier)., Costa BA; Clinical Pharmacology Unit, Drug Research and Development Center (Drs. de Moraes Filho, Costa, Amaral de Moraes, Rodrigues, and Paier). Electronic address: bruno_almeida_costa@hotmail.com., Bruno ZV; Maternity School Assis Chateaubriand (Drs. Bruno and Bezerra), Federal University of Ceará, Fortaleza., Filho MPM; Department of Gynecology and Obstetrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto (Dr. Filho), Brazil., Amaral de Moraes ME; Clinical Pharmacology Unit, Drug Research and Development Center (Drs. de Moraes Filho, Costa, Amaral de Moraes, Rodrigues, and Paier)., Rodrigues FAR; Clinical Pharmacology Unit, Drug Research and Development Center (Drs. de Moraes Filho, Costa, Amaral de Moraes, Rodrigues, and Paier)., Paier CRK; Clinical Pharmacology Unit, Drug Research and Development Center (Drs. de Moraes Filho, Costa, Amaral de Moraes, Rodrigues, and Paier)., Bezerra LRPS; Maternity School Assis Chateaubriand (Drs. Bruno and Bezerra), Federal University of Ceará, Fortaleza.
Jazyk:	angličtina
Zdroj:	Journal of minimally invasive gynecology [J Minim Invasive Gynecol] 2020 Nov - Dec; Vol. 27 (7), pp. 1474-1475. Date of Electronic Publication: 2020 Mar 03.
DOI:	10.1016/j.jmig.2020.02.017
Abstrakt:	Study Objective: Insufficient penile skin is common during vaginoplasty for male-to-female transition. This issue may be compensated by a scrotal skin flap, with the drawback of hair growth [1]. In recent studies, Nile tilapia skin was successfully used for the surgical management of Mayer-Rokitansky-Küster-Hauser syndrome [2,3] and vaginal stenosis [4,5]. This study aims to describe a novel technique for primary vaginoplasty in male-to-female gender-affirming surgery using Nile tilapia skin as a biocompatible graft to ensure adequate vaginal depth. Design: Stepwise demonstration of the procedure with narrated video footage. Setting: Transgender health clinic. Interventions: A 29-year-old patient with gender dysphoria was referred to our office because of a desire for gender-affirming surgery. A physical examination revealed normal male genitalia with a 14-cm-long penis. Before surgery, approval from the institutional review board and written permission from the patient were obtained. After orchiectomy, penile disassembly, perineal dissection, and urethroplasty were performed, and a hollow Nile tilapia skin mold was prepared and sutured to the distal edge of the remaining penile skin. This structure was inverted, covering the newly created canal. The neocavity was then filled with a handmade inflatable vaginal mold, held in place by sutures in the labia majora. Finally, labiaplasty and clitoroplasty were conducted. After 7 days, the inflatable mold was removed, and the use of progressively larger dilators was initiated. After 3 weeks, a neovagina that was 16 cm long and able to accommodate the width of 2 fingers was detected. At that time, the Nile tilapia skin was completely reabsorbed into the neovaginal mucosa. There were no complications in the early postsurgical period. Conclusion: Nile tilapia skin, a safe, low-cost, and easy-to-use biocompatible material, may be an alternative option to scrotal skin grafts for neovaginal augmentation in primary vaginoplasty for male-to-female gender transition. However, further studies are needed to confirm this assertive. (Copyright © 2020 AAGL. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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