Schardein JN, Li G, Zaccarini DJ, et al. - Despite prior vaginectomy, a high percentage of transgender men with neourethral strictures present with vaginal cavity remnants. After the pathological assessment, results confirm that all vaginal cavity remnant specimens contain vaginal epithelium that was either incompletely excised or regenerated. Total removal of vaginal tissue primarily or during reconstruction is important given the risk of associated symptoms, while the implications of this residual vaginal epithelium require further investigation.

• Researchers recruited a total of 47 consecutive transgender men who had undergone neourethral stricture repair between January 2014 and December 2020.

• Among these individuals, 18 patients (38%) with a mean age of 37 years (23-59) had undergone excision and obliteration of a vaginal cavity remnant. 78% (14/18) had a prior phalloplasty and 22% (4/18) had a prior metoidioplasty.

• It was shown that primary vaginectomy type was not correlated with whether or not a patient had a vaginal cavity remnant (p=0.12).

• In all vaginal cavity remnant specimens, the histological investigation showed the presence of vaginal epithelium.