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Purpose: Gender-affirming vaginoplasty lacks universally adopted guidelines for perioperative management. With this study, we sought to determine what information patients seek through their surgical journey, as well as the methods by which they prefer to receive this information. Methods: An anonymous survey was emailed to 30 patients who underwent gender-affirming vaginoplasty between September 2018 and September 2020. The survey was composed of Likert-scale items that explored the importance of various topics. Patients were also asked from whom and how they received information on specific topics, as well as where they would prefer to get it from. Descriptive statistics and qualitative thematic analyses were used to analyse responses. Results: Seventeen individuals completed the questionnaire (56.6% response rate). All topics received an average rating of moderately important or higher (≧ 3 out of 5 on the Likert scale). Of 30 pre-operative topics queried, participants preferred to receive information in written form for 29 topics (97%), and from the surgeon for 27 topics (90%). Thematic analysis revealed five main themes: recovery process, satisfaction, trust in healthcare providers, information delivery, and neovaginal dilation and depth. Conclusion: Individuals undergoing gender-affirming vaginoplasty have extensive informational needs and seek this information from their surgical team directly with a combination of written resources and verbal discussion. Participants were especially interested in the importance of neovaginal dilation and being aware of possible complications. Additionally, the importance of cultural competence and building trust with healthcare professionals were key findings in this study, echoing a call for more inclusive providers.

Background: Incidentally diagnosed adrenal masses represent an entity that can result in either long term follow-up, surgical excision, or both. Understanding when and which adrenal masses are ultimately excised surgically is not well understood. We sought to understand the ultimate fate of these incidentalomas using a large population-based dataset. Methods: The primary outcome of the study was determining the trend in adoption of surveillance vs. surgical excision according to socio-demographic, economic, and pathologic indices, and also provider specialty. Secondary outcomes were the assessment of perioperative complications, operative time, surgical approach, hospital stay, and provider specialty (general surgery vs. urology) among the cohort that underwent excision. Results: Out of a total of N.=91,560 adrenal masses, ultimately N.=3375 (3.83%) of these underwent surgical excision. In the surgical excision cohort, the incidence of aldosteronoma, functional adenoma/Cushing's disease, and adrenocortical carcinoma was higher than in the surveillance cohort. Those patients who were older, female, and with higher Charlson Comorbidity indexes (CCI) were less likely to undergo surgical resection. Factors that predicted for an increased probability of resection included obtaining more CT/MRI scans as well as general surgeons as primary physician providers. Over the study period, the vast majority of surgeries were performed by surgeons other than urologists (12.9%) and open and laparoscopic approaches dominated, with the robotic-assisted approach accounting for a minority of the surgical cases (23.9%). The minimally invasive surgery (MIS) approach independently predicted for both lower rates of complications and shorter hospital stay. Conclusions: In the US, adrenal incidentalomas are more likely to undergo surveillance rather than surgical resection. In our study, surgery is mainly offered for functional or malignant disease and the receipt of surgery can vary by physician specialty. A MIS approach independently predicted for both lower rates of complications and shorter hospital stay.

To explore the impact of body mass index (BMI) on the outcomes of gender-affirming vaginoplasty.A cohort consisting of all gender-affirming vaginoplasties in our practice between September 27th, 2018, and September 1st, 2022 were identified, and data were retrospectively collected. Patients were classified as obese if their BMI was ≥30 kg/mA total of 58 patients with a mean follow-up time of 6.9 months were included. Seventeen patients (mean BMI = 36.8 kg/mSimilar results can be achieved with gender-affirming vaginoplasty in obese patients when compared to their nonobese counterparts. Eligibility for this procedure should not be restricted based on BMI alone.

Background: Healthcare professionals (HCPs) on the front lines against COVID-19 may face increased workload, and stress. Understanding HCPs’ risk for burnout is critical to supporting HCPs and maintaining the quality of healthcare during the pandemic. Methods: To assess exposure, perceptions, workload, and possible burnout of HCPs during the COVID-19 pandemic we conducted a cross-sectional survey. The main outcomes and measures were HCPs’ self-assessment of burnout and other experiences and attitudes associated with working during the COVID-19 pandemic. Findings: A total of 2,707 HCPs from 60 countries participated in this study. Fifty-one percent of HCPs reported burnout. Burnout was associated with work impacting household activities (RR=1·57, 95% CI=1·39-1·78, P

INTRODUCTION AND OBJECTIVE:Urethral reconstruction within the context of gender affirming phalloplasty is important as almost half of the patients suffer from some degree of urethral complication p...

INTRODUCTION AND OBJECTIVE:Gender-Affirming Genital Reconstruction (GAGR) involves surgical procedures that are designed to give a sense of congruence between the outer body and the inner self in t...