Mp64-07 Colpectomy Reduces Fistulas in Female-to-Male Gender Affirming Surgeries: A Meta-Analysis

You have accessJournal of UrologyReconstruction: External Genitalia and Urotrauma (Including Transgender Surgery and Traumatic Fistula) II (MP64)1 May 2024MP64-07 COLPECTOMY REDUCES FISTULAS IN FEMALE-TO-MALE GENDER AFFIRMING SURGERIES: A META-ANALYSIS Finn Hennig, Eylon J. Arbel, Alyssa Reese, Adam Greenstein, Ellen Lutnick, Guillaume Farah, and Mark Burke Finn HennigFinn Hennig , Eylon J. ArbelEylon J. Arbel , Alyssa ReeseAlyssa Reese , Adam GreensteinAdam Greenstein , Ellen LutnickEllen Lutnick , Guillaume FarahGuillaume Farah , and Mark BurkeMark Burke View All Author Informationhttps://doi.org/10.1097/01.JU.0001008824.92877.7f.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The reported rate of urethral fistulas after female to male gender affirming surgeries (GAS) ranges from 10% to 68%. There remains a paucity of evidence addressing the widely accepted hypothesis that colpectomy reduces the risk of fistula formation. We aim to use a meta-analysis to describe the correlation between colpectomy and the rate of urethral complications after GAS in transgender men. METHODS: PRISMA guidelines were used to search studies reporting urethral complications of GAS from January 2000 up to August 2023. Surgical technique and outcomes were collected and analyzed using the random-effects model due to the heterogeneity of included study populations. Review Manager (Version 5.4.1) was used to perform analysis (p-value of<0.05 was statistically significant). RESULTS: 36 full-text articles met inclusion criteria with a total of 6,404 patients across all studies. 3458 (54%) underwent metoidioplasty and 2946 (46%) underwent phalloplasty. Not all studies analyzed both strictures and fistulas resulting in different total patients for the individual analyses in this study. The fistula event rate of 19% (1221/6404) was larger than the urethral stricture event rate at 13.9% (809/5802). The odds ratio (OR) of fistula formation after GAS associated with colpectomy was 0.05 [0.03,0.09] with an event rate of 16.3% (955/5844), compared to an OR of 0.90 [0.44,1.84] and event rate of 47.5% (266/560) without colpectomy (p<0.01). Both phalloplasty and metoidioplasty separately showed similar findings with decreased OR of fistula formation in GAS done with colpectomy (p<0.01, p<0.01 respectively). There was no significance in the OR of urethral stricture after GAS with or without colpectomy (p=0.51). Ability to void while standing was assessed in 1758 patients with a median of 100% of patients responding "yes" after both metoidioplasty and phalloplasty [IQR:100%-100%, IQR: 75%-100% respectively]. CONCLUSIONS: GAS in transgender men performed with prior or primary colpectomy was associated with significantly lesser odds of developing urethral. There was no significant difference between the odds of urethral strictures after GAS with or without colpectomy. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1043 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Finn Hennig More articles by this author Eylon J. Arbel More articles by this author Alyssa Reese More articles by this author Adam Greenstein More articles by this author Ellen Lutnick More articles by this author Guillaume Farah More articles by this author Mark Burke More articles by this author Expand All Advertisement PDF downloadLoading ...