EAU-USANZ session delivers updates in the region
Female-to-male (FTM) gender reassignment surgery and the practice patterns of female urologists in Australia and New Zealand were examined during the Joint Session of the European Association of Urology (EAU) and the Urological Society of Australia and New Zealand (USANZ). This Urology Beyond Europe session was chaired by Prof. Peter Heathcote (AU) and Prof. Manfred Wirth (DE).
In her lecture, “Practice patterns of female urologists in Australia and New Zealand: Do we need to know?”, Dr. Lydia Johns Putra (AU) disclosed that more women in Australia and New Zealand are joining the urology workforce. She added that on average, they are younger than their male counterparts and are mainly general urologists. They do not take as much time off and intend to retire aged between 60 and 69. Dr. Putra also stated they are more likely to have children but fewer children per individual; work shorter hours; and are more likely to subspecialise compared to female urologists in the United States.
FTM surgery
“We have successfully established an expert service for gender reassignment surgery in Brisbane, Australia,” said Dr. Hans Goossen (AU) during his presentation “Female to male gender reassignment surgery Australia: Early experience and outcome”. Metoidioplasty (also known as Meta), Radial Artery Forearm Flap (RAP), Antero-Lateral Thigh Flap (ALT) and Pubic Phalliplasty (PP) are surgical procedures currently offered in the region.
In the first two years of practice, a total of 17 patients have undergone procedures: 13 RAP, 2 ALT, 1 PP and 1 Meta. However, not all patients went through all stages. Complications, functional outcomes, and measures on patient-reported outcome were assessed.
Dr. Goossen stated that complication rates appear similar to the reported literature; no complete loss of phallus, no major complications of donor sites, and no cardiovascular events. He added that overall patient satisfaction in terms of phallus cosmesis is high (54% rated excellent and 46% good) and that the majority of patients rated scrotum cosmesis as excellent (22%), good (67%) and average (11%). Patients also reported excellent and good urine flow (60% and 10% respectively).
A total of 54% patients had complete sensation of the phallus, and 46% had near completion. 60% reported penile implant use, with 100% adequate implant rigidity. Patients’ gender dysphoria was resolved in 31%, with the other 69% reporting great improvement.