科研之友
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摘要
Objective: To investigate the role of MRI in the evaluation of both the new female anatomy and complications in male-to-female sex reassignment surgery (MtF-SRS). Methods: 71 consecutive patients with MtF-SRS had 74 MRI [age range, 21-63 years; mean (6standard deviation) age, 36 +/- 10 years; median age, 37 years]. In 47 patients, MRI was performed to rule out early post-operative complications after gender conversion (n=40), vaginoplasty (n=6) or remodelling of the labia majora (n=1). In 27 patients, MRI was performed 1-20 years after MtF-SRS for late post-operative complications, pain or dysuria, inflammatory changes or poor cosmetic outcome. Three patients had MRI both before and after the operation. Results: MRI allowed investigation of the new female anatomy in all cases. Soon after MtF-SRS, a small amount of blood was identified in all patients around the neoclitoris, urethral plaque and labia. Post-operative complications were clinically significant fluid collections (n=5), labial abscesses (n=2), severe cellulitis (n=3), partial neovaginal prolapse (n=3), focal necrosis and dehiscence of the vaginal wall (n=2) and hypovascularization of the neoclitoris (n=1). After ileal vaginoplasty, three patients developed clinically insignificant haematomas, one a large rectovaginal fistula with dehiscence of the intestinal anastomosis and bowel perforation (n=1). In the 27 patients investigated 1-20 years after MfF-SRS, MRI demonstrated cavernosal remnants (n=10), spared testis (n=1) neovaginal strictures (n=8), fistulas and abscesses (n=3) and prolapse (n=2). Three of these patients also had fibrotic changes. In the remaining three patients, no pathological features were identified. Conclusion: After genital reconfiguration, MRI allows assessment of the post-operative anatomy and of postoperative complications. Advances in knowledge: Imaging features of the new anatomy and of surgical complications after SRS are discussed and illustrated.
- 出版日期2017
