Outcomes of penile inversion vaginoplasty and robotic-assisted peritoneal flap vaginoplasty in obese and nonobese patients

Neurourol Urodyn. 2023 Jun;42(5):939-946. doi: 10.1002/nau.25077. Epub 2022 Dec 7.

Abstract

Aim: To explore the impact of body mass index (BMI) on the outcomes of gender-affirming vaginoplasty.

Methods: A cohort consisting of all gender-affirming vaginoplasties in our practice between September 27th, 2018, and September 1st, 2022 were identified, and data were retrospectively collected. Patients were classified as obese if their BMI was ≥30 kg/m2 at the time of surgery and nonobese if their BMI was <30 kg/m2 . Complications were assigned a Clavien-Dindo grade and grouped as Grade ≥2 versus Grade ≤1. Patient-reported functional outcomes of intact erogenous sensation, tactile sensation, ability to achieve penetrative vaginal intercourse, and cosmetic satisfaction were assessed.

Results: A total of 58 patients with a mean follow-up time of 6.9 months were included. Seventeen patients (mean BMI = 36.8 kg/m2 ) were classified as obese and 41 patients (mean BMI = 25.1 kg/m2 ) were classified as nonobese. No significant differences in outcomes were identified in the obese versus nonobese groups in terms of the incidence of complications. Patient-reported functional outcomes did not differ significantly between the two groups.

Conclusions: Similar results can be achieved with gender-affirming vaginoplasty in obese patients when compared to their nonobese counterparts. Eligibility for this procedure should not be restricted based on BMI alone.

Keywords: obesity; outcomes; robotics; transgender; vaginoplasty.

Publication types

  • Review

MeSH terms

  • Female
  • Gender-Affirming Surgery* / adverse effects
  • Gender-Affirming Surgery* / methods
  • Humans
  • Obesity / complications
  • Obesity / surgery
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Robotic Surgical Procedures* / adverse effects
  • Surgical Flaps / surgery
  • Vagina / surgery