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Treatment of Urethral Strictures in Transmasculine Patients

Background: Urethral strictures are a common complication after genital gender-affirming surgery (GGAS) in transmasculine patients. Studies that specifically focus on the management of urethral strictures are scarce. The aim of this systematic review is to collect all available evidence on the manag...

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Autores principales: Waterschoot, Mieke, Claeys, Wietse, Hoebeke, Piet, Verla, Wesley, Waterloos, Marjan, Wirtz, Michel, Buncamper, Marlon, Lumen, Nicolaas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8432136/
https://www.ncbi.nlm.nih.gov/pubmed/34501359
http://dx.doi.org/10.3390/jcm10173912
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author Waterschoot, Mieke
Claeys, Wietse
Hoebeke, Piet
Verla, Wesley
Waterloos, Marjan
Wirtz, Michel
Buncamper, Marlon
Lumen, Nicolaas
author_facet Waterschoot, Mieke
Claeys, Wietse
Hoebeke, Piet
Verla, Wesley
Waterloos, Marjan
Wirtz, Michel
Buncamper, Marlon
Lumen, Nicolaas
author_sort Waterschoot, Mieke
collection PubMed
description Background: Urethral strictures are a common complication after genital gender-affirming surgery (GGAS) in transmasculine patients. Studies that specifically focus on the management of urethral strictures are scarce. The aim of this systematic review is to collect all available evidence on the management of urethral strictures in transmasculine patients who underwent urethral lengthening. Methods: We performed a systematic review of the management of urethral strictures in transmasculine patients after phalloplasty or metoidioplasty (PROSPERO, CRD42021215811) with literature from PubMed, Embase, Web of Science and Cochrane. Preferred Reporting Items for Systematic reviews and Meta-Analysis-(PRISMA) guidelines were followed, and risk of bias was assessed for every individual study using the 5-criterion quality appraisal checklist. Results: Eight case series were included with a total of 179 transmasculine patients. Only one study discussed the management of urethral strictures after metoidioplasty. Urethral strictures were most often seen at the anastomosis between the fixed and pendulous urethra. For each stricture location, different techniques have been reported. All studies were at a high risk of bias. The current evidence is insufficient to favor one technique over another. Conclusions: Different techniques have been described for the different clinical scenarios of urethral stricture disease after GGAS. In the absence of comparative studies, however, it is impossible to advocate for one technique over another. This calls for additional research, ideally well-designed prospective randomized controlled trials (RCTs), focusing on both surgical and functional outcome parameters.
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spelling pubmed-84321362021-09-11 Treatment of Urethral Strictures in Transmasculine Patients Waterschoot, Mieke Claeys, Wietse Hoebeke, Piet Verla, Wesley Waterloos, Marjan Wirtz, Michel Buncamper, Marlon Lumen, Nicolaas J Clin Med Review Background: Urethral strictures are a common complication after genital gender-affirming surgery (GGAS) in transmasculine patients. Studies that specifically focus on the management of urethral strictures are scarce. The aim of this systematic review is to collect all available evidence on the management of urethral strictures in transmasculine patients who underwent urethral lengthening. Methods: We performed a systematic review of the management of urethral strictures in transmasculine patients after phalloplasty or metoidioplasty (PROSPERO, CRD42021215811) with literature from PubMed, Embase, Web of Science and Cochrane. Preferred Reporting Items for Systematic reviews and Meta-Analysis-(PRISMA) guidelines were followed, and risk of bias was assessed for every individual study using the 5-criterion quality appraisal checklist. Results: Eight case series were included with a total of 179 transmasculine patients. Only one study discussed the management of urethral strictures after metoidioplasty. Urethral strictures were most often seen at the anastomosis between the fixed and pendulous urethra. For each stricture location, different techniques have been reported. All studies were at a high risk of bias. The current evidence is insufficient to favor one technique over another. Conclusions: Different techniques have been described for the different clinical scenarios of urethral stricture disease after GGAS. In the absence of comparative studies, however, it is impossible to advocate for one technique over another. This calls for additional research, ideally well-designed prospective randomized controlled trials (RCTs), focusing on both surgical and functional outcome parameters. MDPI 2021-08-30 /pmc/articles/PMC8432136/ /pubmed/34501359 http://dx.doi.org/10.3390/jcm10173912 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Waterschoot, Mieke
Claeys, Wietse
Hoebeke, Piet
Verla, Wesley
Waterloos, Marjan
Wirtz, Michel
Buncamper, Marlon
Lumen, Nicolaas
Treatment of Urethral Strictures in Transmasculine Patients
title Treatment of Urethral Strictures in Transmasculine Patients
title_full Treatment of Urethral Strictures in Transmasculine Patients
title_fullStr Treatment of Urethral Strictures in Transmasculine Patients
title_full_unstemmed Treatment of Urethral Strictures in Transmasculine Patients
title_short Treatment of Urethral Strictures in Transmasculine Patients
title_sort treatment of urethral strictures in transmasculine patients
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8432136/
https://www.ncbi.nlm.nih.gov/pubmed/34501359
http://dx.doi.org/10.3390/jcm10173912
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