Comparison of hysterectomy techniques in a group of patient operated for the diagnosis female to male transsexualism
Abstract
Objective: Comparison of duration of surgery, blood loss, complications, lenght of post-operative hospitalisation and post-operative morbidity in a group of patient operated for the diagnosis FtM transsexualism. Material: In our set of patients were 163 FtM transsexuals with caryotype 46 XX and normal gynecological finding (81 virgins).
They were operated on from 1998-2012 at Department of Obstetrics and Gynecology The First Faculty of Medicine Charles University in Prague and Hospital Na Bulovce after at least of 12 months of hormonal preparation. Methods: We used following types of hysterectomy and bilateral adnexectomy: total abdominal hysterectomy from infraumbilical median laparotomy (AHL) or from suprapubic transverse incision - Pfannenstiel (AH), laparoscopically assisted vaginal hysterectomy (LAVH), total laparoscopic hysterectomy (TLH).
In two patients TLH and colpectomy was performed in one setting. Results: In the 23 AHL group the duration of the surgery was 54 minute, blood loss was 226 ml and the length of post-operative hospitalisation was 6.7 days.
In the 22 individualy of AH group the duration of the surgery was 60 minute, blood loss was 240 ml and the length of post-operative hospitalisation was 6.1 days. In 4 patients of LAVH group the duration of the surgery was 73 minute, blood loss 200 ml and the length of post-operative hospitalisation was 5 days.
In the TLH group (112 pts) the duration of the surgery was 91 minutes, blood loss was 121 ml and the length of post-operative hospitalisation was 4.4 days. In the 2 TLH with colpectomy group the duration of the surgery was 152 minute, blood loss was 250 ml and the length of post-operative hospitalisation was 5.5 days.