Background: We investigated the value of magnetic resonance
imaging (MRI) in the evaluation of sex-reassignment
surgery in male-to-female transsexual patients.
Methods: Ten male-to-female transsexual patients who
underwent sex-reassignment surgery with inversion of
combined penile and scrotal skin flaps for vaginoplasty
were examined after surgery with MRI. Turbo spin-echo
T2-weighted and spin-echo T1-weighted images were
obtained in sagittal, coronal, and axial planes with a 1.5-T
superconductive magnet. Images were acquired with and
without an inflatable silicon vaginal tutor. The following
parameters were evaluated: neovaginal depth, neovaginal
inclination in the sagittal plane, presence of remnants of
the corpus spongiosum and corpora cavernosa, and thickness
of the rectovaginal septum.
Results: The average neovaginal depth was 7.9 cm
(range 5–10 cm). The neovagina had a correct oblique
inclination in the sagittal plane in four patients, no inclination
in five, and an incorrect inclination in one. In seven
patients, MRI showed remnants of the corpora cavernosa
and/or of the corpus spongiosum; in three patients, no
remnants were detected. The average thickness of the
rectovaginal septum was 4 mm (range 3– 6 mm).
Conclusion: MRI allows a detailed assessment of the
pelvic anatomy after genital reconfiguration and provides
information that can help the surgeon to adopt the most
correct surgical approach.
