Are trans men at higher risk for post-hysterectomy VVF than women?

[Shana A]

Are trans men at higher risk for post-hysterectomy VVF than women?

http://genderoutlaw.wordpress.com/2009/09/17/transmen-higher-risk-vvf/

At one of the follow-ups after the diagnosis of my post-hysterectomy vesico vaginal fistula (VVF) I asked my gynecologist if he thought the effects of testosterone on vaginal tissue could have played a role in my complication. He thought for a moment, then replied that he didn't think so.

I was certainly not the first trans man that my surgeon had performed a hysterectomy for, but I don't know just how much recent experience he has with trans men. There's also very little data out there about the effects of testosterone on vaginal tissue. (Trans men are a very understudied population.) However, I have come across references that state the following:

[Miniar]

Oh.. *grumbles*

Seems a hysterectomy before T would be a good idea.
Problem is ofcourse.. Icelandic system mandates that you have 1 full year HRT before Any (transrelated) surgery!

[GamerJames]

It also seems that the article suggests that urethral lengthening would become more risky after being on T:

"Androgenized vaginal tissues are not preferred for urethroplasty because they are weakened."

So for anyone considering bottom surgery, this is troubling as well.

I wonder what can be done about this? It seems that having all surgeries before starting T might not be plausible or even desired for most transguys, and yet how then do we minimize this risk?

Things to think about for sure, and hopefully the medical community is thinking about this too (although, I'm not sure they would be).