Evaluation of BMI as a Risk Factor for Complications following Gender-affirming Penile Inversion Vaginoplasty

Graham C. Ives, Lydia A. Fein, Lindsey Finch, Emily C. Sluiter, Megan Lane, William M. Kuzon, Christopher J. Salgado

Research output: Contribution to journalArticle

Abstract

Background: Gender affirmation surgery (GAS) has a positive impact on the health of transgender patients; however, some centers employ body mass index (BMI) as a strict selection criterion for surgical candidacy. Several single-center studies have found no clear correlation between BMI and complication rates. We conducted a retrospective multicenter study at 2 university-based centers to test the null hypothesis: obesity is not a significant determinant of the risk of acute surgical complications in patients undergoing penile inversion vaginoplasty (PIV). Methods: This is a retrospective chart review of all adult patients at the University of Michigan and the University of Miami undergoing gender-affirming PIV with minimum follow-up time of 3 months between 1999 and 2017. A logistic regression model of analysis is used to examine the predictive factors for surgical complications and delayed revision urethroplasty in our patient sample. Results: One hundred and one patients met inclusion criteria for this study. The mean BMI at the time of procedure was 26.9kg/m2 (range 17.8-48.2). Seventeen patients (16.8%) had major complications and 36 patients (35.6%) had minor complications. On logistic regression analysis, none of the recorded covariates were significant predictors of delayed revision urethroplasty or major, minor, or any complications. Conclusions: We found that obese patients can safely undergo GAS and that BMI alone should not preclude appropriately selected patients from undergoing GAS. We acknowledge that selection based on overall health and other medical comorbidities is certainly warranted for gender-affirming PIV and all other surgical procedures.

Original languageEnglish (US)
Article numbere2097
JournalPlastic and Reconstructive Surgery - Global Open
Volume7
Issue number3
DOIs
StatePublished - Mar 1 2019

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Body Mass Index
Logistic Models
Regression Analysis
Transgender Persons
Health
Patient Selection
Multicenter Studies
Comorbidity
Retrospective Studies
Obesity

ASJC Scopus subject areas

  • Surgery

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Evaluation of BMI as a Risk Factor for Complications following Gender-affirming Penile Inversion Vaginoplasty. / Ives, Graham C.; Fein, Lydia A.; Finch, Lindsey; Sluiter, Emily C.; Lane, Megan; Kuzon, William M.; Salgado, Christopher J.

In: Plastic and Reconstructive Surgery - Global Open, Vol. 7, No. 3, e2097, 01.03.2019.

Research output: Contribution to journalArticle

Ives, Graham C. ; Fein, Lydia A. ; Finch, Lindsey ; Sluiter, Emily C. ; Lane, Megan ; Kuzon, William M. ; Salgado, Christopher J. / Evaluation of BMI as a Risk Factor for Complications following Gender-affirming Penile Inversion Vaginoplasty. In: Plastic and Reconstructive Surgery - Global Open. 2019 ; Vol. 7, No. 3.
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