MP64-11 NOT SO KOI: FISH SKIN ALLOGRAFT (KERECIS™) FOR REVISION GENDER-AFFIRMING VAGINOPLASTY

Abstract

You have accessJournal of UrologyReconstruction: External Genitalia and Urotrauma (Including Transgender Surgery and Traumatic Fistula) II (MP64)1 May 2024MP64-11 NOT SO KOI: FISH SKIN ALLOGRAFT (KERECIS™) FOR REVISION GENDER-AFFIRMING VAGINOPLASTY Andrew Drozd, Anish Patel, Kelly Chambers, Elaine Yang, Rachel Pope, Kyle Scarberry, Kirtishri Mishra, and Shubham Gupta Andrew DrozdAndrew Drozd , Anish PatelAnish Patel , Kelly ChambersKelly Chambers , Elaine YangElaine Yang , Rachel PopeRachel Pope , Kyle ScarberryKyle Scarberry , Kirtishri MishraKirtishri Mishra , and Shubham GuptaShubham Gupta View All Author Informationhttps://doi.org/10.1097/01.JU.0001008824.92877.7f.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Many patients require revision surgery for loss of depth or caliber of the vaginal canal after a gender-affirming vaginoplasty. In these cases, lack of local skin necessitates the use of flaps, autologous grafts, or allografts. Kerecis is an intact fish-skin allograft that can act as a scaffold for epithelialization and has emerged as a novel tool in wound management. Here, we assessed outcomes of revision vaginoplasty (RV) utilizing Kerecis fish-skin allograft material for canal deepening in the setting of inadequate remnant tissue in transgender patients at our institution. We hypothesize that incorporation of Kerecis graft into the revision will provide durable outcomes after RV. METHODS: We conducted a retrospective analysis of 12 patients who underwent RV using Kerecis with or without autologous flaps for vaginal stenosis and/or canal deepening. The time from index vaginoplasty to revision and revised vaginal depth were recorded. Other outcomes of interest included surgical and subjective patient outcomes, complications, as well as the ability to perform post-operative dilation. RESULTS: The median time from index vaginoplasty to revision with Kerecis was 275 days. Three patients underwent a robotic peritoneal pull through revision vaginoplasty. The mean vaginal depth prior to revision was 3.45 cm. Mean revised vaginal depth in the operating room was 13.55 cm. All patients were able to dilate at their initial post-operative visit. All were satisfied with their outcomes. Only one patient required additional revision due to lack of compliance with dilation four months after RV. There were no operative complications following RV in this group of patients. CONCLUSIONS: Kerecis, an intact fish-skin allograft, is an efficacious tool in surgical wound management by acting as a scaffold for epithelialization. In this group of patients undergoing RV, incorporating Kerecis into the revision improved vaginal depth while providing durable patient outcomes, notably the ability to dilate at follow-up. Moving forward, Kerecis may serve as an effective means to improve long term outcomes after RV in patients with inadequate native tissue. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1045 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Andrew Drozd More articles by this author Anish Patel More articles by this author Kelly Chambers More articles by this author Elaine Yang More articles by this author Rachel Pope More articles by this author Kyle Scarberry More articles by this author Kirtishri Mishra More articles by this author Shubham Gupta More articles by this author Expand All Advertisement PDF downloadLoading ...