Ovid MEDLINE, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, and Web of Science. The resulting publications were screened, and those that met our specified inclusion/exclusion criteria analyzed. The DerSimonian and Laird random effects model was used to pool complications and patient-reported outcomes. RESULTS: A total of 471 articles were initially identified, of which 46 met our eligibility criteria. A total of 3716 cases were analyzed. Overall incidence of complications

more »

... luded 2% (95% CI 1% to 6%) fistula, 14% (95% CI 10% to 18%) stenosis and strictures, and 1% (95% CI 0% to 6%) tissue necrosis, and 4% (95% Cl 2% to 10%) prolapse. Patient reported outcomes included a satisfaction rate of 93% (95% Cl 79% to 100%) with overall results, 87% (95% Cl 75% to 96%) with function outcome, and 90% (95% Cl 79% to 98%) with aesthetic outcome. Ability to have orgasm was reported in 70% (95% Cl 54% to 84%) of patients. The regret rate was 1% (95% Cl 0% to 3%). The width of the vaginal cavity was 12.5 cm (95% Cl 6.3 cm to 14.4 cm). CONCLUSION: Multiple surgical techniques have demonstrated safe and reliable means of male to female vaginoplasty with low overall complication rates, and significant improvements in patient quality of life. Studies utilizing different techniques in a similar population and standardized patient-reported outcomes are required to further analyze outcomes among the different procedures and to establish best-practice guidelines.