Gender Confirmation Surgery Using the Pedicle Transverse Colon Flap for Vaginal Reconstruction: A Clinical Outcome and Sexual Function Evaluation Study

Introduction: Vaginal reconstruction and vaginoplasty are indicated in vaginal agenesis, following pelvic tumor resection, trauma and for gender confirmation surgery. Different surgical options have been described when using these techniques. Herein, we present the clinical outcomes and sexual function evaluation using the pedicle transverse colon flap (TCF) for gender confirmation surgery in transgender women. Methods: This is a retrospective chart review of all transgender women who underwent gender confirmation surgery using the pedicle TCF. Demographics, etiology, procedure specifics and surgical outcomes were recorded and analyzed. Sexual function was measured using the Female Sexual Function Index (FSFI) and the female genital self-image scale (FGSIS) one year after surgery. Results: 15 patients underwent gender confirmation surgery using the pedicle transverse colon flap. Average age was 20, (range: 18-32 years), average OR time was 10.1 hours; (8-12.5 hrs.). The average length and width of the flaps was 15 cm and 2.8 cm respectively. During a 12-year follow-up, two complications were reported: one patient had pain due to narrowing at the introitus vaginalis, which required intervention and one patient had excessive amount of secretions in the first month which subsided at the third month after surgery. The mean FSFI score was 28.6 (range 24-31). All patients achieved a normal sexual function as indicated by a FSFI score of 25 or more. For the FGSIS, the mean total score was 20.0 ± 4.5 (range: 7- 28). Conclusion: The pedicle transverse colon flap is another valuable alternative method for vaginoplasty with promising results and minor complications. Financial Disclosure:None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript. Corresponding Author: Oscar J. Manrique M.D., Senior Associated Consultant, Assistant Professor of Surgery, Division of Plastic and Reconstructive Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, Tel: +1-507-284-3214; Fax: +1-507-284-5994, Email: manrique.oscar@mayo.edu ©2017American Society of Plastic Surgeons