{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T18:30:51Z","timestamp":1790706651643,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Andrology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Direct comparison of robot\u2010assisted peritoneal flap (PF) to penile inversion (PI) vaginoplasty for gender affirming surgery is absent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We sought to compare these two techniques to aid patient decision\u2010making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective case\u2013control study of patients who underwent primary PI (\n                      <jats:italic>N<\/jats:italic>\n                      = 40) or PF (\n                      <jats:italic>N<\/jats:italic>\n                      = 40) vaginoplasty by one of two surgeons at a single center from 2020 to 2023 was conducted.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      PF yielded greater vaginal depth at 1 month (18\u00a0cm [13\u201320] vs. 15\u00a0cm [4.0\u201323],\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      &lt;\u00a00.01) and 6 months (18\u00a0cm [11\u201320] vs. 15\u00a0cm [2.5\u201319],\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      &lt;\u00a00.01) compared to PI, despite shorter preoperative phallic skin length. No rectal injuries occurred with PF versus three with PI. PF had less estimated blood loss than PI (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.01). Length of stay, operative time, vaginal stenosis, vault granulation tissue, and transfusion rates were similar among groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This early institutional experience demonstrated that primary PF yielded longer perioperative vaginal depth compared to PI with short\u2010term stability at 6 months, despite shorter preoperative phallic skin length. Complication rates were similar among techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both PF and PI are safe options for gender affirming vaginoplasty with low risk of complications that warrant ongoing use and future study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/andr.70351","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T12:40:51Z","timestamp":1786711251000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Robot\u2010Assisted Peritoneal Flap Vaginoplasty Versus Penile Inversion Vaginoplasty for Gender Affirming Surgery"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7912-8976","authenticated-orcid":false,"given":"Chantal J.","family":"Allan","sequence":"first","affiliation":[{"name":"Division of Urology Department of Surgery University of Alberta  Edmonton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"Sljivich","sequence":"additional","affiliation":[{"name":"Department of Urology Mount Sinai Hospital  New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Kahan","sequence":"additional","affiliation":[{"name":"Albert Einstein College of Medicine  Bronx USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5491-4786","authenticated-orcid":false,"given":"Camille","family":"Torres","sequence":"additional","affiliation":[{"name":"Department of Urology Mount Sinai Hospital  New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0547-8452","authenticated-orcid":false,"given":"Michael","family":"Palese","sequence":"additional","affiliation":[{"name":"Department of Urology Mount Sinai Hospital  New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miroslav","family":"Djordjevic","sequence":"additional","affiliation":[{"name":"Department of Urology Mount Sinai Hospital  New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajveer S.","family":"Purohit","sequence":"additional","affiliation":[{"name":"Department of Urology Mount Sinai Hospital  New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"issue":"7","key":"e_1_2_9_2_1","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1001\/jamasurg.2017.6231","article-title":"Temporal Trends in Gender\u2010Affirming Surgery Among Transgender Patients in the United States","volume":"153","author":"Canner J. 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