![]() ![]() At our institution, we perform the classic penile inversion vaginoplasty (PIV), with an inverted penis skin flap used as the lining for the neovagina. Gender-affirming surgery (GAS) is increasingly recognized as a therapeutic intervention and a medical necessity, with growing societal acceptance ( 2). To be eligible for this surgery, transsexual individuals must have been adherent to multidisciplinary follow-up for at least 2 years, have a minimum age of 21 years (required for surgical procedures of this nature), have a positive psychiatric or psychological report, and have a diagnosis of GD. Our program offers psychosocial support, health care, and guidance to families, and refers individuals for gender-affirming surgery (GAS) when indicated. ![]() Since 1998, the Gender Identity Program (PROTIG) of the Hospital de Clínicas de Porto Alegre (HCPA), Universidade Federal do Rio Grande do Sul, Brazil has provided public assistance to transsexual people, is the first one in Brazil and one of the pioneers in South America. Gender identity-affirming care, for those who desire, can include hormone therapy and affirming surgeries, as well as other procedures such as hair removal or speech therapy ( 1). The terms describe a situation where an individual's gender identity differs from external sexual anatomy at birth ( 1). Transsexualism (ICD-10) or Gender Dysphoria (GD) (DSM-5) is characterized by intense and persistent cross-gender identification which influences several aspects of behavior ( 1). Otherwise, in our series, there were a high level of functionality of the neovagina, as well as subjective personal satisfaction. One hundred eighty-one (85 percent) patients in our series were able to have regular sexual intercourse, and no individual regretted having undergone GAS.Ĭonclusions: Findings confirm that it is a safety procedure, with a low incidence of serious complications. A total of 36 patients (16.8 percent) underwent some form of reoperation. The most commons minor postoperative complications were granulation tissue (20.5 percent) and introital stricture of the neovagina (15.4 percent) and the major complications included urethral meatus stenosis (20.5 percent) and hematoma/excessive bleeding (8.9 percent). Results: Results demonstrate that the average age at the time of surgery was 32.2 years (range, 18–61 years) the average of operative time was 3.3 h (range 2–5 h) the average duration of hormone therapy before surgery was 12 years (range 1–39). During this period, 214 patients underwent penile inversion vaginoplasty. In the current study, a retrospective cohort, we report the 20-years outcomes of the gender-affirming surgery performed at a single Brazilian university center, examining demographic data, intra and postoperative complications. In this context, surgery is imperative to achieve a successful gender transition and plays a key role in alleviating the associated psychological discomfort. Purpose: Gender dysphoria (GD) is an incompatibility between biological sex and personal gender identity individuals harbor an unalterable conviction that they were born in the wrong body, which causes personal suffering. ![]() 3Serviço de Psiquiatria, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.2Serviço de Psiquiatria, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.1Serviço de Urologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.Gabriel Veber Moisés da Silva 1 *, Maria Inês Rodrigues Lobato 2, Dhiordan Cardoso Silva 2, Karine Schwarz 2, Anna Martha Vaitses Fontanari 2, Angelo Brandelli Costa 3, Patric Machado Tavares 1, Antonio Rebello Horta Gorgen 1, Renan Desimon Cabral 1 and Tiago Elias Rosito 1
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