Current opinion in urology · 2026
Urethral complications after gender-affirming genital surgery: prevention and reconstructive management.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Neuville Paul, Madec François-Xavier, Morel-Journel Nicolas, Trauma and Reconstructive Urology Working Party of the European Association of Urology Young Academic Urologists
Аннотация
PURPOSE OF REVIEW: Urethral complications remain a major source of morbidity following gender-affirming genital surgery, particularly in the setting of masculinizing procedures requiring urethral lengthening. This review summarizes recent advances in the epidemiology, prevention, and reconstructive management of urethral complications, with a focus on principles relevant to reconstructive urologists.
RECENT FINDINGS: Urethral complications are uncommon after feminizing genital surgery but occur frequently following masculinizing surgery, with pooled rates of strictures and fistulae approaching 50% after phalloplasty. Recent studies emphasize the heterogeneity of these complications, highlighting the importance of timing, anatomical location, and surgical technique. Improved classification systems, such as the Montréal classification, aim to standardize reporting. Preventive strategies - including careful patient selection, expectation management, hair removal protocols, optimized flap design, tissue interposition, and staged reconstruction - are increasingly recognized as critical but remain underreported. Reconstructive management must be individualized, as outcomes are influenced by tissue vascularity and prior interventions. Staged urethroplasty appears to offer the most durable results for complex strictures, while prolonged urinary diversion may allow conservative resolution of selected fistulae.
SUMMARY: Urethral complications after masculinizing gender-affirming genital surgery are common and complex. Emphasis on prevention, standardized reporting, and individualized reconstructive strategies is essential to improve long-term urinary outcomes.
RECENT FINDINGS: Urethral complications are uncommon after feminizing genital surgery but occur frequently following masculinizing surgery, with pooled rates of strictures and fistulae approaching 50% after phalloplasty. Recent studies emphasize the heterogeneity of these complications, highlighting the importance of timing, anatomical location, and surgical technique. Improved classification systems, such as the Montréal classification, aim to standardize reporting. Preventive strategies - including careful patient selection, expectation management, hair removal protocols, optimized flap design, tissue interposition, and staged reconstruction - are increasingly recognized as critical but remain underreported. Reconstructive management must be individualized, as outcomes are influenced by tissue vascularity and prior interventions. Staged urethroplasty appears to offer the most durable results for complex strictures, while prolonged urinary diversion may allow conservative resolution of selected fistulae.
SUMMARY: Urethral complications after masculinizing gender-affirming genital surgery are common and complex. Emphasis on prevention, standardized reporting, and individualized reconstructive strategies is essential to improve long-term urinary outcomes.