Vaginal approach versus laparoscopy for hysterectomy in transgender men.

Autor: Ozceltik G; From the Department of Obstetrics and Gynecology, Ege University Faculty of Medicine, Izmir 35100, Turkey. Electronic address: gokayozceltik@hotmail.com., Hortu I; From the Department of Obstetrics and Gynecology, Ege University Faculty of Medicine, Izmir 35100, Turkey., Itil IM; From the Department of Obstetrics and Gynecology, Ege University Faculty of Medicine, Izmir 35100, Turkey., Yeniel AO; From the Department of Obstetrics and Gynecology, Ege University Faculty of Medicine, Izmir 35100, Turkey.
Jazyk: angličtina
Zdroj: Journal of gynecology obstetrics and human reproduction [J Gynecol Obstet Hum Reprod] 2022 Feb; Vol. 51 (2), pp. 102286. Date of Electronic Publication: 2021 Dec 12.
DOI: 10.1016/j.jogoh.2021.102286
Abstrakt: Study Objective: To describe a vaginal approach combining vaginal hysterectomy (VH) with transvaginal natural orifice transluminal endoscopic surgery (vNOTES) bilateral salpingo-oophorectomy (BSO) for hysterectomy in transgender men and to evaluate the feasibility, safety, and surgical outcomes of this approach in comparison with laparoscopy.
Material and Methods: Retrospective cohort study comparing outcomes of the vaginal approach (n = 45) and laparoscopy (n = 45) in transgender men undergoing hysterectomy between May 2017 and June 2020.
Results: There was one intraoperative complication (bladder injury) in the laparoscopy group, which was the reason for the only conversion from the initial surgical approach. All vaginal procedures were completed without any intraoperative complications or conversions. Patients in the vaginal approach group had shorter operative times compared to the laparoscopy group (median 60 [range, 30-130] vs median 85 [range, 63-179] minutes; P < 0.001). One patient in the vaginal approach group experienced late-onset intraabdominal bleeding and underwent reoperation on postoperative day 4 after failed expectant management. There were no reoperations in the laparoscopy group. Patients in the vaginal approach group experienced less pain at postoperative 12 h and 24 h (P values < 0.001 and < 0.001, respectively). Postoperative hospital stay was shorter in the vaginal approach group than in the laparoscopy group (median 2 [range, 1-7] vs. median 2 [range, 2-6] days; P < 0.001). There were no readmissions within 30 days after surgery in either group.
Conclusion: The vaginal approach combining VH with vNOTES BSO is a feasible and safe alternative to laparoscopy for hysterectomy in transgender men.
Competing Interests: Declaration of Competing Interest The authors declare that they have no conflicts of interest and nothing to disclose.
(Copyright © 2021. Published by Elsevier Masson SAS.)
Databáze: MEDLINE
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