The gynecologic examination of the transfeminine person after penile inversion vaginoplasty
| Autor: | Hillary McLaren, Meredith Gray, Frances Grimstad |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Scope of practice Physical examination Vulva 03 medical and health sciences Gynecologic Surgical Procedures 0302 clinical medicine Health care Transgender Sex Reassignment Surgery medicine Humans 030212 general & internal medicine Pelvic examination 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry General surgery Obstetrics and Gynecology medicine.anatomical_structure Vagina Vaginoplasty Female Gynecological Examination business Transsexualism Penis |
| Zdroj: | American Journal of Obstetrics and Gynecology. 224:266-273 |
| ISSN: | 0002-9378 |
| Popis: | As more transfeminine patients (transgender and gender-diverse persons, sex assigned male at birth, who identify on the feminine spectrum of gender) are undergoing gender-affirming penile inversion vaginoplasty, gynecologists, as providers of vaginal care for both native and neovaginas, should be prepared to welcome these patients into their practice and offer long-term pelvic healthcare. Many parts of the anatomy, clinical examination, and aftercare differ from both native vaginas and other neovaginal surgical techniques. Transgender and gender-diverse patients cite a lack of clinician knowledge as a barrier to accessing affirming and competent healthcare. Although publications are emerging regarding this procedure, most focus on intraoperative and postoperative complications. These studies are not positioned to provide long-term pelvic health guidance or robust instruction on typical examination findings. This clinical opinion aims to address that knowledge gap by describing the gynecologic examination in the transfeminine person who has undergone a penile inversion vaginoplasty. We review the anatomic changes with surgery and the neovagina's physiology. We describe the examination of the vulva, vagina, and urethra and discuss special considerations for performing pelvic examinations on patients with a penile inversion vaginoplasty neovagina. We will also address common pathologic findings and their initial management. This clinical opinion originates from the expertise of gynecologists who have cared for high volumes of transfeminine patients who have undergone penile inversion vaginoplasties at tertiary care centers performing gender-affirming genital surgery, along with existing research on postpenile inversion vaginoplasty outcomes. Gynecologists should be familiar with the anatomic changes that occur with penile inversion vaginoplasty gender-affirming surgery and how those changes affect care. Providing transgender patients with comprehensive care including this sensitive examination can and should be part of the gynecologist's scope of practice. |
| Databáze: | OpenAIRE |
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