Which Is the Best Surgical Approach for Female-to-Male Sexual Reassignment? A Systematic Review of Hysterectomy and Salpingo-Oophorectomy Options from the Gynecological Perspective
Abstract
:1. Introduction
2. Materials and Methods
2.1. Research Strategy
2.2. Selection Criteria for Full-Text Article Review
2.3. Outcome Measures
2.4. Risk of Bias
2.5. Data Collection
2.6. Novel Surgical Techniques
2.7. Statistical Analysis
3. Results
3.1. Population
3.2. Intervention
3.3. Comparison
3.4. Outcomes
4. Discussion
Limitations and Strengths
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Query | Population | Intervention | Comparison | Outcomes |
---|---|---|---|---|
1 | female-to-male | Hysterectomy and salpingo-oophorectomy | none | v-NOTES/vaginal surgery reduces operative time |
2 | female-to-male | Hysterectomy and salpingo-oophorectomy | none | Laparoscopic/robotic surgery reduce operative time |
3 | female-to-male | Hysterectomy and salpingo-oophorectomy | none | v-NOTES/vaginal surgery reduces intra and postoperative complications |
4 | female-to-male | Hysterectomy and salpingo-oophorectomy | none | Laparoscopic/robotic surgery reduces intra- and postoperative complications |
5 | female-to-male | Hysterectomy and salpingo-oophorectomy | none | v-NOTES/vaginal surgery reduces postoperative pain |
6 | female-to-male | Hysterectomy and salpingo-oophorectomy | none | Laparoscopic/robotic surgery reduces postoperative pain |
7 | female-to-male | Hysterectomy and salpingo-oophorectomy | none | v-NOTES/vaginal surgery reduces hospital stay |
8 | female-to male | Hysterectomy and salpingo-oophorectomy | none | Laparoscopic/robotic surgery reduces hospital stay |
Study and Year | Origin of Study | Patients Enrolled | Age (Mean ± SD) | BMI (Mean ± SD) | Parity (N, %) | Uterine Weight (Mean ± SD) g |
---|---|---|---|---|---|---|
Bogliolo et al., 2014 [19] | Italy | 10 TM | 28 ± 5.7 | 22 ± 1.7 | 0 | Not reported |
Gardella et al., 2021 [21] | Italy | 60 TM | 30.62 ± 7.93 | 23.52 ± 4.26 | 0 | Nor reported |
Giampaolino et al., 2021 [20] | Italy | 20 TM | Median: 23.5 (19.5–28.4) | Median: 22.5 (range: 21–24.7) | Not reported | |
Obedin-Maliver, 2017 [22] | USA | 33 TM | 35.2 ± 69.9 | 27.9 ± 65.4 | 2 (6.1) | Not reported |
Jeftovic et al., 2018 [23] | Serbia | 124 TM | Not reported | Not reported | Not reported | Not reported |
O’Hanlan et al., 2007 [24] | USA | 31.76 ± 7.4 | 27.36 ± 5.8 | 2 (4.9) | 118.02 ± 115.6 | |
Donmez et al., 2024 [16] | Turkey | 83 TM | v-NOTES: 27.57 ± 3.9 TLH: 26.6 ± 4.8 | v-NOTES: 22.9 ± 2.8 TLH: 24.8 ± 4.4 | Not reported | Not reported |
Lee et al., 2018 [18] | Taiwan | 56 TM | VH: 29.3 ± 6.4 v-NOTES: 28.8 ± 7.3 | VH: 23.7 ± 4.4 v-NOTES: 24.3 ± 5.0 | VH:0 v-NOTES:0 | VH: not reported v-NOTES: not reported |
Study and Year | Study Design | Patients Enrolled | Procedure | Operative Time | Blood Loss, mL | Hospital Stay, Days | Visual Analog Scale (VAS) | Intra- and Postoperative Complications, n (%) |
---|---|---|---|---|---|---|---|---|
Bogliolo et al., 2014 [19] | Retrospective study | 10 TM | RSSH and mean ± SD minutes BSO | Mean ± SD minutes Operative time: 137 ± 32. Console time:79 ± 15. Docking time: 9 ± 2 m. | Mean ± SD 30 ± 24 mL | Mean ± SD days 2.4 ± 0.9 | Mean VAS: 1 (interquartile 0–3 at 1 h after surgery) VAS: 0 (interquartile 0–0) at 24 h after surgery | 1 (10) |
Gardella et al., 2021 [21] | Prospective monocentric study | 60 TM | RSSH and BSO | Mean ± SD Total surgical time: 143.77 ± 40.39. Console time: 100.73 ± 32.26. Docking time: 7.72 ± 2.61. | Hb drop mean ± SD: 1.1 ± 0.46 | 3.85 ± 1.26 | Mean ± SD VAS: 4.53 ± 1.73 at 1 h after surgery VAS: 2.35 ± 1.96 | 3 (4.83) |
Giampaolino et al., 2021 [20] | Single-center retrospective study | 20 TM | RH and BSO | Median Operation time: 90 (interquartile 65–150). Docking time: 15 (interquartile 10–25) minutes. Time spent in the operating room: 140 (90–180). | Median 90 (interquartile 150–30) mL Decrease in hemoglobin levels (%): 8 (4–16) | Median 2.5 (interquartile 2–4) | Median VAS: 5 (interquartile 3–8) score in the immediate postoperative period. VAS: 3 (interquartile 1–6) at 24 h after surgery. VAS: 2 (interquartile 0–5) at 28 h after surgery. | Not reported |
Obedin-Maliver, 2017 [22] | Single-center retrospective cohort study | 33 TM | 14 TM: TLH and 13 BSO (one subject only adnexal surgery). 8 TM: VH and BSO. 11 TM: AH and BSO. | Not reported | Median TLH and BSO:175 (interquartile 110–30). VH and BSO: 250 (interquartile 175–400). AH and BSO: 225 (interquartile 200–250). | Not reported | Not reported | 9 (27.3) |
Jeftovic et al., 2018 [23] | Retrospective study | 124 TM | 92 TM: VH and BSO 32 TM: TLH and BSO | Mean VH:51 (interquartile 46–72) TLH: 76 (interquartile 68–90) | Not reported | Mean VH: 4 (interquartile 3–6) TLH 4 (interquartile 3–6) | Not reported | VH: 1 (1%) TLH: 1 (3%) |
O’Hanlan et al., 2007 [24] | Retrospective study | 41 TM | THL and BSO | Mean ± SD 74.08 ± 35.4 | Mean ± SD 26.88 ± 27.7 | Mean ± SD 1.07 ± 0.3 | Not reported | 5 (12.2) |
Donmez et al., 2024 [16] | Retrospective cohort study | 83 TM | 21 TM: v-NOTES and BSO 62 TM: TLH and BSO | mean ± SD: v-NOTES: 126.1 ± 37.9 TLH: 76.1 ± 33.9 | Hemoglobin drop, mean ± SD v-NOTES: 1.5 ± 0.9 In TLH: 1.5 ± 0.9 (0.1–3.4) | Postoperative hospital stay, days: v-NOTES: 1.6 ± 1.01 TLH: 2.9 ± 0.5 | Postoperative pain second hour after surgery, median ± SD v-NOTES: 5 ± 1.56 TLH: 8 ± 1.11 Postoperative 24th hour after surgery, median ± SD TVNH: 1 ± 0.62 TLH: 2 ± 0.9 | 0 |
Lee et al., 2018 [18] | Retrospective study | 56 TM | 42 TM: VH and BSO 14: v-NOTES and BSO | mean ± SD: v-NOTES: 144.3 ± 51.7 VH: 149.2 ± 47.1 | median v-NOTES: 200 (interquartile 100–388) VH:150 mL (interquartile 100–350) | mean ± SD v-NOTES: 7.7 ± 2.4 VH: 7.1 ± 3.1 | VAS at 2 h and 72 h, mean ± SD: v-NOTES: 4.9 ± 3.0 and 1.7 ± 1.0 (n = 12) VH: 7.1 ± 1.4 (n = 42) and 2.7 ± 1.1 (n = 34) | v-NOTES 1 (0.025) VH: 5 (11.9) |
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Dominoni, M.; Gritti, A.; Pano, M.R.; Sandullo, L.; Papa, R.; Torella, M.; Gardella, B. Which Is the Best Surgical Approach for Female-to-Male Sexual Reassignment? A Systematic Review of Hysterectomy and Salpingo-Oophorectomy Options from the Gynecological Perspective. Medicina 2024, 60, 1095. https://doi.org/10.3390/medicina60071095
Dominoni M, Gritti A, Pano MR, Sandullo L, Papa R, Torella M, Gardella B. Which Is the Best Surgical Approach for Female-to-Male Sexual Reassignment? A Systematic Review of Hysterectomy and Salpingo-Oophorectomy Options from the Gynecological Perspective. Medicina. 2024; 60(7):1095. https://doi.org/10.3390/medicina60071095
Chicago/Turabian StyleDominoni, Mattia, Andrea Gritti, Martina Rita Pano, Lucia Sandullo, Rossella Papa, Marco Torella, and Barbara Gardella. 2024. "Which Is the Best Surgical Approach for Female-to-Male Sexual Reassignment? A Systematic Review of Hysterectomy and Salpingo-Oophorectomy Options from the Gynecological Perspective" Medicina 60, no. 7: 1095. https://doi.org/10.3390/medicina60071095