MP02-15: Urologic Outcomes Following Metoidioplasty and Phalloplasty Gender Affirming Surgery (MaPGAS) with Urethral Lengthening: A Modified Delphi Consensus Study
Research Associate New York University Langone Health, University of Michigan Medical School
Introduction: Metoidioplasty and Phalloplasty Gender Affirming Surgery (MaPGAS) performed with urethral lengthening should be customized to the individual patient. Urologic risks remain high, despite an array of surgical options. Due to a dearth of high-quality, primary outcomes studies, setting patient expectations is difficult. This study aims to explore MaPGAS surgeon consensus on expected outcomes. Methods: A purposive sample of MaPGAS surgeons were invited to participate in a two round, modified Delphi, web-based study. Participants in the second round were asked for agreement with statements developed via round one Delphi results, community driven outcomes of interest, and literature review. Responses were anonymous. Statement consensus was defined a priori as =70% agreement and was calculated by the number agreeing with the statement divided by the total number routinely evaluating the outcome. Participants provided free text comments on disagreement, which were categorized into viewing statements as conservative (statement overstates complications, understates desired outcomes), or conversely as optimistic. Results: Twenty-one MaPGAS surgeons were invited and 16 (76%) completed the survey. Thirteen (81%) performed metoidioplasty and 14 statements (93%) reached consensus (Table 1). Thirteen (81%) performed radial forearm (RF) phalloplasty and 8/12 (67%) statements reached consensus, while 10 (63%) performed anterolateral thigh (ALT) phalloplasty and 8 /12 statements (67%) reached consensus (Table 2). Conclusions: Greater consensus exists regarding metoidioplasty outcomes as compared to phalloplasty outcomes. Variations in experience, surgical technique, and outcomes evaluated may contribute to lack of consensus on MaPGAS outcomes. SOURCE OF Funding: 1R21DK124733-01
