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Spartan Med Res J
Spartan Med Res J
1364
Spartan Medical Research Journal
2474-7629
MSU College of Osteopathic Medicine Statewide Campus System Website: Spartan Medical Research Journal

122878
10.51894/001c.122878
Research Symposium
GENDER-AFFIRMING SCROTECTOMY: INITIAL DESCRIPTION AND OUTCOMES
Zoltin Kitan MS 1
1 College of Osteopathic Medicine Michigan State University https://ror.org/05hs6h993
30 8 2024
2024
9 2 ABSTRACTS FROM THE SECOND ANNUAL RESEARCH DAY HOSTED BY THE MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE, NOVI, MICHIGAN, APRIL 11, 2024. 12287815 7 2024
31 7 2024
https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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pmc28

INTRODUCTION

Patients may seek gender-affirming orchiectomy and scrotectomy (GAOS) to alleviate dysphoria related to the scrotum and testes, while allowing for penetrative intercourse, if desired.

OBJECTIVES

Techniques and outcomes of scrotectomy in this specific setting have not been described to date. Here we discuss our initial experience with GAOS as an option for patients who do not necessarily desire other gender-affirming genital surgeries.

METHODS

All patients who had undergone GAOS procedures from 2021 to 2022 at our institution were reviewed. The World Professional Association for Transgender Health (WPATH) criteria for surgical treatment were met for all patients preoperatively. In addition, patients expressed understanding that vaginoplasty would not be recommended after scrotectomy. Patients were offered a choice of two approaches depending on their surgical goals: excision of a majority of scrotal tissue and primary closure of the perineal wound, or excision of all rugated skin with mons and groin (Y-flap) advancement. Preoperative demographic data, baseline sexual function, intraoperative findings, and postoperative outcomes were collected. Patient-reported outcomes (PROs) derived from the PROMIS® Sexual Function questionnaires were sent to all patients postoperatively and collected.

RESULTS

The median operative time was 152 min. All patients were discharged home the same day. All five patients had procedures complicated by the presence of a scrotal web, and two experienced postoperative complications ranging from mild tethering with erections to wound dehiscence requiring skin graft. At median follow-up (97 days), all reported satisfaction with outcomes. Patients who experienced postoperative complications reported no change to their libido and the ability to achieve erection and orgasm. Further patient follow-up is being collected.

CONCLUSIONS

GAOS is a well-tolerated procedure that can reasonably address dysphoria related to the scrotum and testes. It is associated with high satisfaction and a low risk of postoperative complications causing long-term sequelae. Further and long-term study of this emerging procedure is warranted.
