Comparing scrotoplasty complication rates in transgender and cisgender men: An ACS NSQIP study

Nimish Saxena; Divya Jolly; Catherine A. Wu; Elizabeth R. Boskey; Oren Ganor

JPRAS Open (Jun 2023)

Comparing scrotoplasty complication rates in transgender and cisgender men: An ACS NSQIP study

Nimish Saxena,
Divya Jolly,
Catherine A. Wu,
Elizabeth R. Boskey,
Oren Ganor

Affiliations

Nimish Saxena: Boston University School of Medicine, 72 East Concord St. Boston, MA, USA
Divya Jolly: Center for Gender Surgery, Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, USA
Catherine A. Wu: Harvard Medical School, 25 Shattuck St, Boston, MA, USA
Elizabeth R. Boskey: Center for Gender Surgery, Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, USA; Department of Surgery, Harvard Medical School, 25 Shattuck St, Boston, MA, USA; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, USA
Oren Ganor: Center for Gender Surgery, Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, USA; Department of Surgery, Harvard Medical School, 25 Shattuck St, Boston, MA, USA; Corresponding author at: Department of Plastic and Oral Surgery, 300 Longwood Ave. Boston, MA 02115, USA.

Journal volume & issue: Vol. 36
pp. 55 – 61

Abstract

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While masculinizing gender-affirming genital surgeries may include scrotoplasty, there has been limited research on the safety and outcomes of scrotoplasty among transgender men. We compared scrotoplasty complication rates between cisgender and transgender patients using data from the American College of Surgeon's National Surgical Quality Improvement Program (NSQIP) database. Data was queried between 2013 and 2019 for all patients with procedure codes for scrotoplasty. Transgender patients were identified through a gender dysphoria diagnosis code. T-tests and Fisher's exact test were used to identify any differences in demographics, operative characteristics, and outcomes. The primary outcomes of interest were demographic factors, operative details, and surgical outcomes.A total of 234 patients were identified between 2013 and 2019. Fifty were transgender and 184 were cisgender. Age and BMI were significantly different between the two cohorts, such that the cisgender cohort was older (Mtrans = 38 years (SD:14), Mcis = 53 years (SD: 15)) and had higher BMI than the transgender cohort (Mtrans = 26.9 (SD: 5.5), Mcis = 35.2 (SD: 11.2)). Cisgender patients also had poorer overall health (p = 0.001), and were more likely to have hypertension (p = 0.001) and diabetes (p = 0.001). Race and ethnicity did not vary significantly between the cohorts. Operative details differed significantly between cohorts, such that transgender patients had a longer operating time (Mtrans = 303 min (SD: 155), Mcis = 147 min (SD: 107)) and fewer transgender patients had a simple scrotoplasty (p = 0.02). The majority of gender-affirming scrotoplasties were performed by plastic surgeons (62%) whereas the majority of cisgender scrotoplasties were performed by urologists (76%). Despite these demographic and pre-operative differences, the number of patients who underwent complex scrotoplasty experiencing any of the tested complications did not differ by gender. Our results support scrotoplasty as a safe procedure for transgender patients, with no significant differences in outcomes between transgender and cisgender patients.

Published in JPRAS Open

ISSN: 2352-5878 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine: Surgery
Website: https://www.journals.elsevier.com/jpras-open/

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