Regret after Sex Reassignment Surgery in a Male-to-Female Transsexual: A Long-Term Follow-Up

Fifteen years ago the author reviewed the world literature on male transsexualism (Pauly, 1965). Subsequently he summarized the results of sex reassignment surgery for male and female transsexuals (Pauly, 1968), and reviewed the literature on female transsexualism (Pauly, 1974). Very recently, Meyer and Reter (1979) concluded that ‘sex reassignment surgery confers no objective advantage in terms of social rehabilitation’ as compared with a group of individuals who sought sex reassignment but remained unoperated upon at follow-up. Both groups improved over time and led the Johns Hopkins Gender Identity Clinic to conclude that sex reassignment surgery would no longer be offered there. This report, and other non-surgical, psychotherapeutic approaches to gender dysphoric patients (Barlow et al. 1973; Barlow et al. 1979; Lothstein and Levine, 1980) call into question the justification for sex reassignment surgery. Therefore, it becomes important to update the results of sex reassignment surgery for transsexuals. Data on 283 male to female transsexuals and 83 female to male transsexuals are presented.

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Is pharyngeal pouch stapling superior to open pharyngeal pouch repair? An analysis of a single institution's series

The Journal of Laryngology & Otology ◽

10.1017/s0022215116008641 ◽

2016 ◽

Vol 130 (9) ◽

pp. 873-877 ◽

Cited By ~ 5

Author(s):

E Agalato ◽

J Jose ◽

R J England

Keyword(s):

Surgical Procedures ◽

Symptom Control ◽

Open Approach ◽

Pharyngeal Pouch ◽

Female Ratio ◽

Open Procedure ◽

Long Term Follow Up ◽

Male To Female

AbstractBackground:Endoscopic stapling has become the primary procedure for pharyngeal pouch surgery because it is quick, less invasive and safe, but less is known about long-term outcomes.Method:Medical records were reviewed to compare rates of morbidity, operative failure, symptom control and revision surgery between open and closed procedures.Results:A total of 120 pharyngeal pouch procedures, carried out on 97 patients from 2000 to 2014, were studied. These included 80 endoscopic stapling and 40 open procedures. Twelve patients had complications (15 per cent) and there was one mortality (1.2 per cent) in the endoscopic stapling group. Ten patients (25 per cent) developed complications in the open procedure group, with no mortalities. Symptom recurrence was significantly greater in the endoscopic stapling group (26 per cent) than in the open procedure group (7.5 per cent). Multiple surgical procedures were required for 22 endoscopically stapled patients (32 per cent); none were required in the open procedure group. Although the male-to-female ratio for pharyngeal pouch incidence was 2:1, the ratio for multiple surgical procedures was 10:1.Conclusion:Endoscopic stapling outcomes are not as good as those following an open approach on long-term follow up, and the early advantages are eliminated if pouch excision is avoided.

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