{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T11:22:42Z","timestamp":1781263362557,"version":"3.54.1"},"reference-count":69,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T00:00:00Z","timestamp":1724889600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To review the available literature on variant genital gender\u2010affirming surgery (GGAS), including the reasons for performing it, the surgeries themselves and their outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review on the performance of variant GGAS was conducted (International Prospective Register of Systematic Reviews [PROSPERO] identifier: CRD42022306684) researching PubMed, Embase, Web of Science and Cochrane databases from inception up to 31 December 2023. Preferred Reporting Items for Systematic Reviews and Meta\u2010Analyses (PRISMA) guidelines were followed, and risk of bias was assessed for each study using the five\u2010criteria quality assessment checklist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total 23 case series were included, of which 17 on masculinising and six on feminising surgeries. Patients mainly choose these surgical procedures out of personal desire to avoid risk of complication or because they do not have dysphoria about certain parts of their genitalia. Complications in masculinising surgeries primarily arose from the extended urethra, which could be mitigated through primary perineal urethrostomy. Both phalloplasty and metoidioplasty carried a higher risk of urethral complications when the vagina was preserved. In feminising surgeries, risk of visceral damage and requirement for lifelong self\u2010dilation could be avoided when vulvoplasty was performed without vaginal canal creation. All studies had a high risk of bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This review highlights the importance of variant GGAS and acknowledges the preferences of transgender and gender\u2010diverse individuals. Patients should be informed about the risks and benefits of each step in these procedures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.16513","type":"journal-article","created":{"date-parts":[[2024,8,29]],"date-time":"2024-08-29T21:43:44Z","timestamp":1724967824000},"page":"40-53","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Variant genital gender\u2010affirming surgery: a systematic review"],"prefix":"10.1111","volume":"135","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4314-793X","authenticated-orcid":false,"given":"Wietse","family":"Claeys","sequence":"first","affiliation":[{"name":"Department of Urology Ghent University Hospital, An ERN eUROGEN Accredited Center  Ghent Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dylan T.","family":"Wolff","sequence":"additional","affiliation":[{"name":"Department of Urology Wake Forest School of Medicine  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