Urologic outcomes following metoidioplasty and phalloplasty gender affirming surgery (mapgas) with urethral lengthening: a modified delphi consensus study

You have accessJournal of UrologyCME1 Apr 2023MP02-15 UROLOGIC OUTCOMES FOLLOWING METOIDIOPLASTY AND PHALLOPLASTY GENDER AFFIRMING SURGERY (MAPGAS) WITH URETHRAL LENGTHENING: A MODIFIED DELPHI CONSENSUS STUDY Gaines Blasdel, Mang L. Chen, Jens Berli, Geolani Dy, Daniel Dugi, Miroslav Djordjevic, Marta Bizic, Lee Zhao, Loren Schechter, Richard Santucci, Jeremy B. Myers, Isak Goodwin, Dmitriy Nikolavsky, Toby Meltzer, Andrew Watt, Joseph Pariser, Bradley Figler, William Kuzon, Miriam Hadj-Moussa, Benjamin McCormick, Lee Brown, John F. Nigriny, and Rachel A. Moses Gaines BlasdelGaines Blasdel More articles by this author , Mang L. ChenMang L. Chen More articles by this author , Jens BerliJens Berli More articles by this author , Geolani DyGeolani Dy More articles by this author , Daniel DugiDaniel Dugi More articles by this author , Miroslav DjordjevicMiroslav Djordjevic More articles by this author , Marta BizicMarta Bizic More articles by this author , Lee ZhaoLee Zhao More articles by this author , Loren SchechterLoren Schechter More articles by this author , Richard SantucciRichard Santucci More articles by this author , Jeremy B. MyersJeremy B. Myers More articles by this author , Isak GoodwinIsak Goodwin More articles by this author , Dmitriy NikolavskyDmitriy Nikolavsky More articles by this author , Toby MeltzerToby Meltzer More articles by this author , Andrew WattAndrew Watt More articles by this author , Joseph PariserJoseph Pariser More articles by this author , Bradley FiglerBradley Figler More articles by this author , William KuzonWilliam Kuzon More articles by this author , Miriam Hadj-MoussaMiriam Hadj-Moussa More articles by this author , Benjamin McCormickBenjamin McCormick More articles by this author , Lee BrownLee Brown More articles by this author , John F. NigrinyJohn F. Nigriny More articles by this author , and Rachel A. MosesRachel A. Moses More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003213.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Metoidioplasty and Phalloplasty Gender Affirming Surgery (MaPGAS) performed with urethral lengthening should be customized to the individual patient. Urologic risks remain high, despite an array of surgical options. Due to a dearth of high-quality, primary outcomes studies, setting patient expectations is difficult. This study aims to explore MaPGAS surgeon consensus on expected outcomes. METHODS: A purposive sample of MaPGAS surgeons were invited to participate in a two round, modified Delphi, web-based study. Participants in the second round were asked for agreement with statements developed via round one Delphi results, community driven outcomes of interest, and literature review. Responses were anonymous. Statement consensus was defined a priori as ≥70% agreement and was calculated by the number agreeing with the statement divided by the total number routinely evaluating the outcome. Participants provided free text comments on disagreement, which were categorized into viewing statements as conservative (statement overstates complications, understates desired outcomes), or conversely as optimistic. RESULTS: Twenty-one MaPGAS surgeons were invited and 16 (76%) completed the survey. Thirteen (81%) performed metoidioplasty and 14 statements (93%) reached consensus (Table 1). Thirteen (81%) performed radial forearm (RF) phalloplasty and 8/12 (67%) statements reached consensus, while 10 (63%) performed anterolateral thigh (ALT) phalloplasty and 8 /12 statements (67%) reached consensus (Table 2). CONCLUSIONS: Greater consensus exists regarding metoidioplasty outcomes as compared to phalloplasty outcomes. Variations in experience, surgical technique, and outcomes evaluated may contribute to lack of consensus on MaPGAS outcomes. Source of Funding: 1R21DK124733-01 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e17 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Gaines Blasdel More articles by this author Mang L. Chen More articles by this author Jens Berli More articles by this author Geolani Dy More articles by this author Daniel Dugi More articles by this author Miroslav Djordjevic More articles by this author Marta Bizic More articles by this author Lee Zhao More articles by this author Loren Schechter More articles by this author Richard Santucci More articles by this author Jeremy B. Myers More articles by this author Isak Goodwin More articles by this author Dmitriy Nikolavsky More articles by this author Toby Meltzer More articles by this author Andrew Watt More articles by this author Joseph Pariser More articles by this author Bradley Figler More articles by this author William Kuzon More articles by this author Miriam Hadj-Moussa More articles by this author Benjamin McCormick More articles by this author Lee Brown More articles by this author John F. Nigriny More articles by this author Rachel A. Moses More articles by this author Expand All Advertisement PDF downloadLoading ...