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• W2884141567 abstract "Introduction Fecal and urinary incontinence (FUI), are complex public health problems with enormous impact in economy and quality of life. Effective treatments for FUI are insufficient. Another complex subject is dysphoria and some people use the artificially created surgeries for gender reassignment. After research on anorectal transplantation (1-5) and criterious anatomic pelvic floor investigation, we perceived pelvic floor as a composite graft sharing the same vascular pedicle and neuronal trunk. Thus, pelvic floor transplantation (PFT) could be the logical procedure to treat FUI and for gender reassignment in dysphoria. Here we describe the surgical technique for translational research of PFT in rat, sheep and cadavers. Method We performed isotransplantation in twelve Lewis rats and autotransplantation in three female sheep and eight fresh cadavers (two males) for this research. The surgical technique wassimilar for the three species and gender. Pelvic floor harvesting – After a combined perineal (including the genitalia and anus) and abdominal incision, the dissection progresses between abdominal wall, gluteus and the limb’s root, near the pelvic ring bone, preserving all pelvic structures. Through the abdominal incision, the aorta vena cava, internal iliac vessels, gonadal vessels and pudendum were isolated. The graft containing aorta and vena cava in continuity with the internal iliac vessels, pudendum, skin, muscular complex, ligaments, bladder, ureter, vagina or penile, rectum, anus, uterus and ovarian (female), testis (male) and its ducts was flashed by cold solution, removed and cold stored. Graft implantation – Aorta-aorta and cava-cava anastomosIs were performed. We also performed anastomosis between the donor and the recipient ureter, rectum and pudenda nerves and vessels. To complete the operation, the pelvic floor was repositioned in its original position by stitches between pelvic floor ligaments, pudendal nerves, peritoneum, muscles and skin. Conclusion Pelvic floor transplantation surgery is feasible in rat, sheep and cadavers. It could be the logical solution for complex pelvic floor dysfunction causing DI and eventually for gender reassignment in dysphoria.References [1] Galvão FH, et al. Anorectal transplantation. Tech Coloproctol. 2009 Mar;13(1):55-9.[2] Galvão FH, et al. Allogeneic anorectal transplantation in rats: technical considerations and preliminary results. Sci Rep. 2016 Aug 4;6:30894. [3] Seid VE, et al. Functional outcome of autologous anorectal transplantation in an experimental model.Br J Surg. 2015 Apr;102(5):558-62. [4] Galvão FH, et al. Intestinal transplantation including anorectal segment in the rat. Microsurgery. 2012;32(1):77-9. [5] Galvao FH, et al. An innovative model of autologous anorectal transplantation with pudendal nerve reconstruction. Clinics (Sao Paulo). 2012 Aug;67(8):971-2." @default.
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• W2884141567 date "2018-07-01" @default.
• W2884141567 modified "2023-10-18" @default.
• W2884141567 title "Surgical Technique for Pelvic Floor Transplantation" @default.
• W2884141567 doi "https://doi.org/10.1097/01.tp.0000543871.58266.5d" @default.
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