V12-03: Autologous Rectus Fascial Pubovaginal Sling After Vaginoplasty: An Old Trick for a New Problem
There is an increasing number of vaginoplasties performed for gender incongruence in the United States. Some of these patients may have had prior treatment for prostate cancer, and as a result, urologists may be confronted with unusual complications in these patients that have not been reported in the literature.
A 68-year-old transfemale who has had a radical prostatectomy and mild post-operative incontinence subsequently developed total incontinence after vaginoplasty. An artificial urinary sphincter was not possible because of the dramatically shortened bulbar urethra. We describe treatment with a pubovaginal sling using autologous rectus fascia. The patient was counseled about the likelihood of urinary retention post-operatively and the need for intermittent catheterization which she agreed to do.
The patient was dry one month after surgery but did require intermittent catheterization to empty her bladder.
Autologous pubovaginal sling may be an option to treat incontinence in the transgender female. Unusual complications may occur after transgender surgery and familiarity with reconstructive male and female surgical techniques can be helpful.
Funding: Institute for Bladder and Prostate Research