Vaginectomy and laparoscopically assisted vaginal hysterectomy as adjunctive surgery for female-to-male transsexual reassignment: preliminary report

Objective: Reassignment surgery of the female-to-male transsexual is a rare ly performed surgical procedure that should involve a gynecologist's consul tation and expertise. This study examines the experience with this type of surgery at Baskent University Hospital, Ankara, Turkey, from the gynecologi sts' point of view. Study design: Eight patients underwent laparoscopically assisted vaginal hysterectomy, bilateral salpingo-oophorectomy and total v aginectomy, followed by phallic construction. Patients were followed up for 9 to 30 months post-surgery. Results: The average operative time for total vaginectomy and laparoscopically assisted vaginal hysterectomy and bilater al salpingo-oophorectomy was 2 h and 20 min. The estimated average blood lo ss was 250 ml. Other than one bladder perforation, which was repaired immed iately and healed uneventfully, we encountered no operative or postoperativ e complications Linked to the gynecologic surgery. Conclusion: Laparoscopy seems to be useful in female-to-male transsexual surgery in allowing the pr eservation of structures vital for phallic construction, such as inferior e pigastric vessels and the rectus abdominis muscle. The application of vagin ectomy awaits justification through long-term follow-up studies of transsex uals who have undergone colpocleisis. (C) 1999 Elsevier Science Ireland Ltd . All rights reserved.