Mp02-17 complications following vaginoplasty for gender affirmation using a claims database

You have accessJournal of UrologyCME1 Apr 2023MP02-17 COMPLICATIONS FOLLOWING VAGINOPLASTY FOR GENDER AFFIRMATION USING A CLAIMS DATABASE Jessica Schardein, Liem Snyder, Masaya Jimbo, Kevin Hebert, Joshua Horns, Nathan Driggs, Rupam Das, Jeremy Myers, and James Hotaling Jessica SchardeinJessica Schardein More articles by this author , Liem SnyderLiem Snyder More articles by this author , Masaya JimboMasaya Jimbo More articles by this author , Kevin HebertKevin Hebert More articles by this author , Joshua HornsJoshua Horns More articles by this author , Nathan DriggsNathan Driggs More articles by this author , Rupam DasRupam Das More articles by this author , Jeremy MyersJeremy Myers More articles by this author , and James HotalingJames Hotaling More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003213.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Transfeminine genital reconstructive surgery is an important part of gender affirmation for many transgender women. Currently, various vaginoplasty techniques are performed by surgeons across the United States. While surgical outcomes have been previously reported by individual surgeons and groups, complications using an insurance claims database have yet to be reported. Our objective is to present complication rates among surgeons using a large claims database. METHODS: A retrospective review was conducted of all transgender women who underwent vaginoplasty using IBM MarketScan claims database between 2011-2020. Baseline patient characteristics such as age, obesity, smoking status, Charlson Comorbidity Index (CCI) and the region surgery was performed were obtained. Patients were followed after surgery to identify complications. Common surgical complications, including bleeding/hematoma, wound dehiscence, postsurgical infection, DVT, PE, and MI, and complications specific to gender affirming surgery, such as rectal injury, urinary issues, urethral stricture, loss of neovaginal depth, and prolapse, were investigated using ICD-9/ICD-10 and CPT codes. Hazard ratios (HRs) were calculated to determine how baseline factors influenced complications. RESULTS: A total of 1588 privately insured patients who underwent vaginoplasty for gender affirmation with 414 different surgeons were identified. Mean age was 34 years (22-53 years), 16% were obese and 8% were smokers. The majority (70%) of patients had a CCI of 0. Overall, at a mean follow-up of 14 months (5-28 months), 66% of patients had a complication. A common surgical complication occurred in 19% and a gender affirming surgery complication occurred in 61%. Among those with a gender affirming surgery complication, <1% had a rectal injury, 21% had urinary issues, 19% had a urethral stricture, 16% had loss of neovaginal depth and 15% had prolapse (Table 1). Smoking was the only factor that was found to have a statistically significant HR for both common and gender affirming complications (1.48 and 1.26, respectively; p<0.05). CONCLUSIONS: Post-vaginoplasty, the majority of patients have at least one complication based on claims data. All patients should be counseled on smoking cessation prior to surgery to potentially decrease the rate of complications. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e18 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jessica Schardein More articles by this author Liem Snyder More articles by this author Masaya Jimbo More articles by this author Kevin Hebert More articles by this author Joshua Horns More articles by this author Nathan Driggs More articles by this author Rupam Das More articles by this author Jeremy Myers More articles by this author James Hotaling More articles by this author Expand All Advertisement PDF downloadLoading ...