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Single Versus Two-stage Phalloplasty For Transgender Female To Male Patients: Does Staged Phalloplasty Influence In Rate Of Complications?
Maria T. Huayllani, MD1, Daniel Boczar, MD1, Humza Y. Saleem, MD1, Gabriela Cinotto, MD1, Oscar J. Manrique, MD2, Pedro Ciudad, MD, PhD3, Antonio Jorge Forte, MD, PhD, MS1.
1Mayo Clinic, Jacksonville, FL, USA, 2Mayo Clinic, Rochester, MN, USA, 3Arzobispo Loayza National Hospital, Lima, Peru.

PURPOSE: Phalloplasty is the main treatment for gender dysphoria disorder. It is difficult to ascertain if staging of phalloplasty influences the rate of complications. We aim to describe and compare the rates of complication between single versus two-stage phalloplasty for transgender female to male patients.
METHODS: PubMed database was queried for studies reporting complications of female to male transgender patients who underwent phalloplasty. The keywords "phalloplasty", "female to male", "outcome", "complication" and synonyms in different combinations were used for the search. Only studies that could identify whether phalloplasty was performed in a single or two-stage procedure were included.
RESULTS: From a total of 70 articles, 15 met the inclusion criteria. Twelve studies reported complications associated with a single-stage phalloplasty and five studies identified complications after a two-stage phalloplasty. The most common complications found for both groups of staging were fistula, stricture and total/partial flap necrosis. Patients who were treated with a two-stage phalloplasty had higher complication rates compared with single-stage phalloplasty (P<0.05).
CONCLUSION: This systematic review identified the impact of staging in the rate of complications related to phalloplasty; a two-stage phalloplasty has a higher rate of complications than a single-stage procedure.


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