Reconstructive Management Pearls for the Transgender Patient

Geolani W. Dy, Jeff Sun, Michael A. Granieri, Lee C. Zhao

Research output: Contribution to journalReview articlepeer-review

29 Scopus citations


Purpose of Review: A growing number of transgender patients are seeking gender-affirming genital reconstructive surgery (GRS). These complex procedures have high complication rates. We describe common surgical pitfalls in GRS and approaches for minimizing complications. Recent Findings: Penile inversion vaginoplasty has been associated with excellent cosmetic and functional outcomes. A robotic-assisted dissection may minimize risk of rectal injury. As a younger transgender population chooses pubertal suppression, alternative sources for lining the vaginal canal, such as enteric vaginoplasties, may be more widely utilized. Since adoption of microvascular techniques in phalloplasty, transmasculine individuals have potential for a sensate neophallus and penetrative intercourse. Urethral complications are common and challenging to manage; techniques using flap coverage may minimize ischemia-related strictures. Innovations in prosthesis placement require adaptations to neophallus anatomy. Summary: A growing number of transgender individuals are seeking genital reconstruction. Ongoing innovation in surgical technique is needed to improve patient outcomes.

Original languageEnglish (US)
Article number36
JournalCurrent urology reports
Issue number6
StatePublished - Jun 1 2018
Externally publishedYes


  • Penile prosthesis
  • Phalloplasty
  • Transgender
  • Urethral stricture
  • Vaginoplasty

ASJC Scopus subject areas

  • Urology


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