A new study shows that most people who undergo gender reassignment surgery are satisfied with their sexual health post-operatively, but that complications can occur.
“Most patients are satisfied,” said study author Maria Helena Palma Sircili, MD, a urologist at the University of San Paulo in Brazil who presented the findings at the recent American Urological Association 2013 Annual Scientific Meeting.
SRS has been performed in Brazil since 1997. Surgeons at the University of San Paulo have performed the procedures 70 times over a 13-year period.
Fifty male-to-female patients underwent orchiectomy and 1-stage vaginoplasty (penile inversion). Twenty female-to-male patients underwent hysterectomy with colpectomy [colpocleisis?] followed by metoidioplasty with urethroplasty in a 2- or 3-stage procedure.
The mean age of the patients was 35 years. The mean study follow-up was 6.5 years.
Results With MTF Surgery
40% of male-to-female patients experienced complications:
- 4 patients lost their neovagina (1 because of hematoma and 3 because of total vaginal prolapse with rectovaginal fistulas);
- 4 had partial vaginal prolapse corrected (1 with laparoscopy and 3 with suprapubic suspension);
- 1 had a prolapsed labia majora requiring removal of the glans;
- 1 had compartmental syndrome in the left leg that was treated with fasciotomy;
- 2 suffered urinary dysfunction that resolved on its own;
- 1 had hair in the labia minora and introitus;
- 6 had urethral meatal stenosis, which was treated with meatotomy;
- 1 had urethral prolapse that was corrected with resection.
The rate of re-operation declined from 45% in the first 20 patients to 30% in the second 20 patients. This is very important to note—that complication rate went down as surgeon experience went up—especially when you compare the experience of SRS surgeons in Brazil to top SRS clinics:
|SRS Clinic||Experience: SRS Performed|
|Brazil||70 SRS patients total (FTM + MTF) over 13 years|
|Ghent, BE||Over 1500 vaginoplasties performed in total, 300+ radial forearm phalloplasties since 1992 – Dr. Stan Monstrey|
|Montreal, CA||200+ SRS patients per year – Dr. Pierre Brassard|
Sexual Satisfaction In Post-Op Women
The majority of the MTF patients (80%) reported having sexual intercourse; for most, this included orgasm. Three said they had no desire for a relationship. Four were still recovering, and 3 are scheduled for re-operation.
Results With FTM Surgeries
Less information about SRS for trans men was reported. Of the 60% who have completed the 3-stage process, two experienced urethral stenosis. The mean length of the phalluses was about 5 cm.
No information about sexual satisfaction was mentioned. For more information about post-op sexual health for trans men, see the following studies:
Quality of Life and Sexual Health after Sex Reassignment Surgery in Transsexual Men
Katrien Wierckx, Eva Van Caenegem, Els Elaut, David Dedecker, Fleur Van de Peer, Kaatje Toye, Steven Weyers MD, Piet Hoebeke MD, Stan Monstrey MD, Griet De Cuypere MD, Guy T’Sjoen MD. The Journal of Sexual Medicine, Volume 8, Issue 12, pages 3379–3388, December 2011.
Genital sensitivity after sex reassignment surgery in transsexual patients.
Selvaggi G, Monstrey S, Ceulemans P, T’Sjoen G, De Cuypere G, Hoebeke P. Ann Plast Surg. 2007 Apr;58(4):427-33.