Conclusion In our experience, a more proximal position of the sutures to fix the penoscrotal apex to the Denonvilliers fascia guarantees a lower risk of prolapse. Furthermore, being a retrospective analysis, it was not possible to verify when the prolapse occurred after SRS. In our opinion, it has several advantages. In reality, in our experience the sacropexy results are difficult in patients who have undergone ileal vaginoplasty because the ileal walls are not easily stretched with respect to the penal scrotal graft that on the other hand results in having a much more malleable and extendable and resistant wall and therefore is more adequate for this type of surgery. Long-term outcomes of prolapse treatment in transsexual patients are not available in literature.
Patients must learn how to perform the dilations well, without stretching the penoscrotal flap.
Conflict of Interests The authors declare that there is no conflict of interests regarding the publication of this paper. However, in our experience, all of the prolapses occurred within 6 months from SRS, and we believe that a crucial role in prolapse prevention is performed postoperatively by patients. The use of abundant lubrication, with the aim of reducing friction during dilatations and intercourse, which can cause detachment of the skin cylinder and prolapse, is crucial.
Authors have not preferred prolapse after 62 consecutive patients were treated with this technique [ 7 ].