为了比较跨性别患者和顺性别患者在微创子宫切除术后的阴道套裂率2015 年 1 月至 2021 年 12 月期间与我们的研究外科医生一起进行的恶性、预防性）。美国大型、城市、学术三级护理医院。166 名患者符合纳入标准，其中 49 名（29.5%）接受 MIH 的性别患者肯定。其余 117 名患者中，92 名 (78.6%) 因癌症接受 MIH，15 名 (12.8%) 因预防而接受 MIH，10 名 (8.5%) 因良性适应症接受 MIH。 不适用 测量：我们评估了患者的基线人口统计数据、是否存在风险阴道套囊裂开的因素、索引子宫切除术的详细信息以及套囊裂开事件的详细信息。跨性别患者在手术时往往较年轻，但两组之间的人口统计数据相似。大多数变性患者（n = 36，73.5%）在子宫切除术时切除了双侧卵巢，100%的患者在术前和术后接受睾酮治疗，并且没有人使用补充雌激素。 49 名变性患者中，有 3 名 (6.1%) 出现术后阴道口裂开，而 117 名顺性别患者中有 2 名 (1.7%) 出现术后阴道口裂开。这未能达到统计显着性，但我们的描述性分析表明，顺性别组中的所有裂开病例都有可识别的诱发因素（即创伤）。相比之下，跨性别组中的所有裂开病例都是自发的，几乎没有可识别的危险因素。接受 MIH 的跨性别患者发生 VCD 的风险可能会增加，尽管这种手术并发症的罕见性妨碍了在我们的数据集中确定统计显着性。我们认为睾酮暴露是阴道套裂的一个可能的危险因素，但我们不能排除其他因素，例如年轻，是该人群中 VCD 的驱动因素。未来需要对生物样本进行研究来评估这些患者的细胞差异。版权所有 © 2023。由 Elsevier Inc. 出版。

To compare rates of vaginal cuff dehiscence in transgender patients with cisgender patients after minimally invasive hysterectomy DESIGN: We performed a single-surgeon, retrospective cohort analysis comparing the rates of vaginal cuff dehiscence in patients undergoing minimally invasive hysterectomy for gender affirmation versus other indications (benign, malignant, prophylactic) with our study surgeon between January, 2015, and December, 2021.Major, urban, academic tertiary care hospital in the United States.166 patients met inclusion criteria with 49 (29.5%) of those patients undergoing MIH for gender affirmation. Of the remaining 117 patients, 92 (78.6%) underwent MIH for cancer, 15 (12.8%) for prophylaxis, and 10 (8.5%) for benign indications.N/A MEASUREMENTS: We assessed included patients for baseline demographics, presence of risk factors for vaginal cuff dehiscence, details of index hysterectomy, and details of cuff dehiscence events.Transgender patients tended to be younger at the time of surgery, but demographics were otherwise similar between both groups. Most transgender patients (n=36, 73.5%) had both ovaries removed at the time of hysterectomy, 100% were on testosterone therapy pre- and post-operatively, and none used supplementary estrogen. Three of the 49 transgender patients (6.1%) experienced postoperative dehiscence of the vaginal cuff compared with two (1.7%) of the 117 cisgender patients. This failed to reach statistical significance, however our descriptive analysis showed that all cases of dehiscence in the cisgender group had identifiable precipitating factors (i.e. trauma). By comparison, all cases of dehiscence in the transgender group were spontaneous with few identifiable risk factors.Transgender patients undergoing MIH may be at increased risk for VCD, though the rarity of this surgical complication precluded determination of statistical significance in our data set. We propose testosterone exposure as a possible risk factor for vaginal cuff dehiscence, though we cannot exclude other factors, such as young age, as drivers of VCD in this population. Future studies of biospecimens are needed to evaluate for cellular differences in these patients.Copyright © 2023. Published by Elsevier Inc.