Gender-affirming surgery has become a more common procedure in the last 5 years. Feminizing genitoplasty typically involves inversion of penile skin as a neovagina, urethral shortening, and glans reduction to create a neoclitoris. Masculinizing genitoplasty is more complex, typically is performed in multiple stages, and has more inherent urologic risks.
The most common urologic complications involve voiding dysfunction, specifically meatal stenosis or fistula to the urinary tract. Urethral stricture, fistula, urinary retention, and voiding dysfunction are very common and require early recognition and intervention. This includes placement of catheter drainage, if necessary with the appropriate urologic instrumentation. Genital risks relating to phallus health are rare, but risks associated with placement of penile prosthesis for sexual function are common and require immediate attention. Urological complications after gender-affirming surgery are common, and the general urologist and urogynecologist should be able to identify and treat problems in this population after review of this chapter.
Current urology reports. 2019 Apr 30*** epublish ***
Campbell Bryson, Stanton C Honig
Department of Urology, Yale School of Medicine, 789 Howard Avenue, FMP 302, New Haven, CT, 06519, USA., Department of Urology, Yale School of Medicine, 330 Orchard St. Suite 164, New Haven, CT, 06511, USA. .