The following is a summary of “Incidence and Risk Factors for Postoperative Venous Thromboembolism After Gender Affirming Vaginoplasty: A Retrospective Analysis of a Large Insurance Claims Database,” published in the December 2023 issue of Urology by Snyder, et al.

For a study, researchers sought to investigate the incidence of venous thromboembolism (VTE) following gender-affirming vaginoplasty and identify associated risk factors.

Using the International Business Machines Corporation (IBM) Marketscan database, we searched for Current Procedural Terminology and International Classification of Diseases (ICD) procedure codes to identify patients who underwent gender-affirming vaginoplasty between 2011 and 2020. They assessed the occurrence of deep venous thrombosis and pulmonary embolism within 90 days post-surgery using relevant ICD-9 and ICD-10 codes. Univariate and multivariate analyses were conducted to determine associations between VTE events and factors such as age, residency location, and comorbidities.

A total of 1,588 patients who underwent gender-affirming vaginoplasty were identified. The overall incidence of postoperative VTE within 90 days was 1.1%. Patients who experienced postoperative VTE tended to be older, have a history of prior VTE, reside in rural areas, and exhibit a higher Charlson Comorbidity Index score. Notably, 47.1% of patients with postoperative VTE had a history of previous VTE, compared to 1.3% among those without postoperative VTE.

Among patients undergoing gender-affirming vaginoplasty, the incidence of postoperative VTE was 1.1%. Older age, rural residency, increased comorbidities, and prior VTE history were associated with a higher risk of postoperative VTE. While current guidelines do not recommend discontinuation of gender-affirming hormone therapy (GAHT) before vaginoplasty, further investigation is warranted to determine whether perioperative adjustments to GAHT or prophylactic measures against VTE may benefit certain high-risk patients.

Reference: goldjournal.net/article/S0090-4295(23)00830-0/abstract