{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T02:37:20Z","timestamp":1784255840403,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T00:00:00Z","timestamp":1673395200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Importance<\/jats:title><jats:p>Vaginoplasty is a relatively common gender\u2010affirming\u00a0surgery with approximately 200 Ontarians seeking this surgery annually. Although Ontario now offers vaginoplasty in province, the capacity is not meeting demand; the majority of trans and gender\u2010diverse patients continue to seek vaginoplasty out of province. Out\u2010of\u2010province surgery presents a barrier to accessing postsurgical follow\u2010up care leaving most patients to seek support from their primary care providers or providers with little experience in gender\u2010affirming surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To provide an account of the common postoperative care needs and neovaginal concerns of Ontarians who underwent penile inversion vaginoplasty out of province and presented for care at a gender\u2010affirming surgery postoperative care clinic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design, Settings, and Participants<\/jats:title><jats:p>A retrospective chart review of the first 80 patients presenting to a gender\u2010affirming\u00a0surgery postoperative care clinic who had undergone vaginoplasty at an outside surgical center was performed. Descriptive analyses were performed for all variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The sample consisted of 80 individuals with the mean age of 39\u2009years (19\u201373). Most patients had surgery at another surgical center in Canada (76.3%). Many patients (22.5%) accessed care in the first 3\u2009months after surgery, with the majority (55%) seeking care within the first perioperative year. Most patients (61.3%) were seen for more than one visit and presented with more than two symptoms or concerns.<\/jats:p><jats:p>Common patient\u2010reported symptoms during clinical visit included pain (53.8%), dilation concerns (46.3%), and surgical site\/vaginal bleeding (42.5%). Sexual function concerns were also common (33.8%) with anorgasmia (11.3%) and dyspareunia (11.3%) being the most frequent complications. The most common adverse outcomes identified by health care providers included hypergranulation (38.8%), urinary dysfunction (18.8%), and wound healing issues (12.5%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Relevance<\/jats:title><jats:p>Findings from chart review offer valuable insights into the postoperative needs and neovaginal concerns of Ontarians who have had vaginoplasty out of province. This study demonstrates the need for routine postoperative care in patients undergoing vaginoplasty. Patients experience numerous symptoms and concerns that often correlate with clinical findings and require multiple follow\u2010up appointments. Health care providers may benefit from further education on the more common nonsurgical issues identified in this study.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.25132","type":"journal-article","created":{"date-parts":[[2023,1,11]],"date-time":"2023-01-11T16:35:28Z","timestamp":1673454928000},"page":"523-529","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Patient reported symptoms and adverse outcomes seen in Canada's first vaginoplasty postoperative care clinic"],"prefix":"10.1002","volume":"42","author":[{"given":"Emery","family":"Potter","sequence":"first","affiliation":[{"name":"Women's College Research Institute Women's College Hospital Toronto Ontario Canada"},{"name":"Lawrence S. Bloomberg Faculty of Nursing University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marudan","family":"Sivagurunathan","sequence":"additional","affiliation":[{"name":"Women's College Research Institute Women's College Hospital Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Women's College Research Institute Women's College Hospital Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy C","family":"Barker","sequence":"additional","affiliation":[{"name":"Women's College Research Institute Women's College Hospital Toronto Ontario Canada"},{"name":"Department of Psychiatry University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janice","family":"Du Mont","sequence":"additional","affiliation":[{"name":"Women's College Research Institute Women's College Hospital Toronto Ontario Canada"},{"name":"Dalla Lana School of Public Health University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianni R.","family":"Lorello","sequence":"additional","affiliation":[{"name":"Women's College Research Institute Women's College Hospital Toronto Ontario Canada"},{"name":"Department of Anesthesiology and Pain Medicine University of Toronto Toronto Ontario Canada"},{"name":"Department of Anesthesia and Pain Management University Health Network \u2010 Toronto Western Hospital Toronto Ontario Canada"},{"name":"The Wilson Centre University Health Network Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3487-9079","authenticated-orcid":false,"given":"Alexandra","family":"Millman","sequence":"additional","affiliation":[{"name":"Women's College Research Institute Women's College Hospital Toronto Ontario Canada"},{"name":"Transition Related Surgery Program, Women's College Hospital University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Urbach","sequence":"additional","affiliation":[{"name":"Women's College Research Institute Women's College Hospital Toronto Ontario Canada"},{"name":"Transition Related Surgery Program, Women's College Hospital University of Toronto Toronto Ontario Canada"},{"name":"Department of Surgery Women's College Hospital Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yonah","family":"Krakowsky","sequence":"additional","affiliation":[{"name":"Women's College Research Institute Women's College Hospital Toronto Ontario Canada"},{"name":"Transition Related Surgery Program, Women's College Hospital University of Toronto Toronto Ontario Canada"},{"name":"Division of Urology, Department of Surgery University of Toronto Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,11]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"BauerG.Estimating Unmet Need for OHIP\u2010Funded Sex Reassignment Surgeries: A Report Prepared for the Ministry of Health and Long\u2010Term Care of Ontario;2010."},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000003510"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.23001"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/00224499.2014.893553"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.5489\/cuaj.6610"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soard.2016.12.025"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000082"},{"key":"e_1_2_10_9_1","unstructured":"Rainbow Health Ontario. Health in Focus: Transition\u2010Related Surgery (TRS) Post\u2010Surgical Care; 2021."},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13178-017-0295-8"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000002684"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jsm.12868"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000001350"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(93)90148-I"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003236"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/15532730903383799"},{"key":"e_1_2_10_17_1","doi-asserted-by":"crossref","unstructured":"GarciaMM.Strategies to Optimize Sexual Function with Feminizing and Masculinizing Genital Gender\u2010Affirming Surgery. In:SchechterLS ed.Gender Confirmation Surgery: Principles and Techniques for an Emerging Field.Springer;2020:215\u2010228.","DOI":"10.1007\/978-3-030-29093-1_21"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/240761"},{"key":"e_1_2_10_19_1","volume-title":"Comprehensive Care of the Transgender Patient","author":"Ferrando CA","year":"2019"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.21037\/tau.2019.06.03"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2020.10.002"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/DSS.0000000000002059"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00152193-200508000-00014"},{"issue":"10","key":"e_1_2_10_24_1","first-page":"1171","article-title":"Retrospective studies and chart reviews","volume":"49","author":"Hess DR","year":"2004","journal-title":"Respir Care"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/26895269.2020.1725710"}],"container-title":["Neurourology and Urodynamics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.25132","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/nau.25132","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/nau.25132","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T10:56:15Z","timestamp":1692528975000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/nau.25132"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,11]]},"references-count":24,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["10.1002\/nau.25132"],"URL":"https:\/\/doi.org\/10.1002\/nau.25132","archive":["Portico"],"relation":{},"ISSN":["0733-2467","1520-6777"],"issn-type":[{"value":"0733-2467","type":"print"},{"value":"1520-6777","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,11]]},"assertion":[{"value":"2022-08-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}