157 Common and Uncommon Complications after M to F Gender Affirming Genital Surgery with Vaginoplasty

Transgender people today represent approximately 0.6% of the adult population (1.4 million people). Genital gender affirming surgery (vaginoplasty) for transgender women has been a covered benefit by MediCare, MediCal, and in an increasing number of U.S. states, commercial health insurance plans due to state laws that bar exclusion of provision by insurance plans. There is not yet an accepted “gold standard” vaginoplasty technique, or, approach to preventing or managing complications. Because many patients present to general urologists for management of short and long-term complications after surgery, how to manage such complications is relevant to general urologists and reconstructive urologists not specialized in gender affirming surgery. We present here a review of common and uncommon complications after surgery, and how we propose such complications arise. We review management approaches. Outcomes and complications from vaginoplasties performed over a 2-year period by a single-surgeon are reviewed. In addition, post-operative complications among patients who underwent vaginoplasty elsewhere but who presented to our institutions for management, are reviewed.