Comparison of Three Hysterectomy Methods in a Set of Female to Male Transsexuals

Abstract PURPOSE: The aim of our study was to compare three widely used surgical techniques of hysterectomy in the well defined sub-population of patients undergoing hysterectomy - FtM transsexuals. MATERIAL AND METHODS OF INVESTIGATION: Hysterectomy with bilateral adnexectomy was performed in 61 FtM transsexuals; patients were randomized into three categories: abdominal hysterectomy through a lower midline laparotomy (AHL), abdominal hysterectomy through a low transverse incision (AH), and total laparoscopic hysterectomy (TLH). METHODS OF ASSESSING THE RESULTS: The criteria studied were duration of surgery, blood loss and the length of post-operative hospitalization. The incidence of complications was also recorded. RESULTS: Mean blood loss (136 ml) in the TLH patients was significantly lower than in either the AH (217 ml) or the AHL (226 ml) patients. Similarly, the length of post-operative hospitalization was significantly shorter for TLH (4.7 days) than for AH (6.4 days) and AHL (6.7 days). However, the duration of the surgery was significantly longer in TLH group (110 minutes) than with either the AH (55 minutes) or AHL (54 minutes). Differences between the AH and AHL procedures were not significant in any of the three studied criteria. DISCUSSION, CONCLUSIONS: In our set of patients TLH was associated with lower blood loss and shorter hospital stay compared to the laparotomic procedures and we found no post-operative complications in TLH patients. The only significant disadvantage was longer duration of TLH procedure compared to the open procedures. Based on our experience, we regard TLH as the method of choice in the surgical management of the FtM transsexuals.