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Chapter 12 - Urogynecological Disorders

from Section B - Practicing Transgynecology

Published online by Cambridge University Press:  22 December 2022

By
Kathryn Bell ,
Rachel Oliver  and
Tina Rashid
Edited by
Mick van Trotsenburg ,
Rixt A. C. Luikenaar  and
Maria Cristina Meriggiola
Mick van Trotsenburg
Affiliation:
Sigmund Freud PrivatUniversität, Wien
Rixt A. C. Luikenaar
Affiliation:
Rebirth Health Center, Utah
Maria Cristina Meriggiola
Affiliation:
Università di Bologna
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Summary

Urogynecological disorders in trans women are a significant burden to individuals and negatively influence quality of life. For trans women post gender-affirmative surgery (GAS), prevalence of overactive bladder is high, whereas urinary incontinence and pelvic organ prolapse are reported less frequently. The etiology of urogynecological disorders in trans women remains under-investigated, with limited literature available to guide clinicians. We discuss the prevalence, pathophysiology, and management of overactive bladder, urinary incontinence, and pelvic floor dysfunction, including neovaginal lining and pelvic organ prolapse, for trans women, at both pre- and postoperative stages. Urogynecological disorders of trans men are not addressed in this chapter, as this group of persons visits a gynecological office only by exception, and complaints pre-GAS do not differ from cisgender women.

Type
Chapter
Information
Context, Principles and Practice of TransGynecology
Managing Transgender Patients in ObGyn Practice
 , pp. 89 - 96
Publisher: Cambridge University Press
Print publication year: 2022

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References

Irwin, DE, Milsom, I, Hunskaar, S, et al. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol 2006;50(6):1306–1315.Google Scholar
Lai, HH, Shen, B, Rawal, A, Vetter, J. The relationship between depression and overactive bladder/urinary incontinence symptoms in the clinical OAB population. BMC Urol 2016;16(1):60.Google Scholar
Hoebeke, P, Selvaggi, G, Ceulemans, P, et al. Impact of sex reassignment surgery on lower urinary tract function. Eur Urol 2005;47(3):398–402.CrossRefGoogle ScholarPubMed
Kuhn, A, Hiltebrand, R, Birkhäuser, M. Do transsexuals have micturition disorders? Eur J Obstet Gynecol Reprod Biol 2007;131(2):226–230.Google Scholar
Choi, H, Chung, H, Park, JY, Lee, JG, Bae, JH. The influence of androgen deprivation therapy on prostate size and voiding symptoms in prostate cancer patients in Korea. Int Neurourol J 2016;20(4):342.Google Scholar
Barry, MJ, Fowler, FJ Jr, O’Leary, MP, et al. Measurement Committee of the American Urological Association. The American Urological Association symptom index for benign prostatic hyperplasia. J Urol 1992;148(5):1549–1557.Google Scholar
British Association of Urological Surgeons (BAUS). International prostate symptoms score (IPSS) [Internet, PDF]. Available from: www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/IPSS.pdfGoogle Scholar
Dunford, C, Bell, K, Rashid, T. Genital reconstructive surgery in male to female transgender patients: a systematic review of primary surgical techniques, complication profiles, and functional outcomes from 1950 to present day. Eur Urol Focus 2021;7(2):464–471.CrossRefGoogle ScholarPubMed
Dreher, PC, Edwards, D, Hager, S, et al. Complications of the neovagina in male‐to‐female transgender surgery: a systematic review and meta‐analysis with discussion of management. Clin Anat 2018;31(2):191–199.Google Scholar
de Nie, I, de Blok, CJ, van der Sluis, TM, et al. Prostate cancer incidence under androgen deprivation: nationwide cohort study in trans women receiving hormone treatment. J Clin Endocrinol Metab 2020;105(9):e3293–e3299.Google Scholar
Antunes-Lopes, T, Vale, L, Coelho, AM, et al. The role of urinary microbiota in lower urinary tract dysfunction: a systematic review. Eur Urol Focus 2020;6(2):361–369.CrossRefGoogle ScholarPubMed
Birse, KD, Kratzer, K, Zuend, CF, et al. The neovaginal microbiome of transgender women post-gender reassignment surgery. Microbiome 2020;8:1–3.Google Scholar
Brubaker, L, Wolfe, A. The urinary microbiota: a paradigm shift for bladder disorders? Curr Opin Obstet Gynecol 2016;28(5):407.Google Scholar
Dy, GW, Nolan, IT, Hotaling, J, Myers, JB. Patient reported outcome measures and quality of life assessment in genital gender confirming surgery. Transl Androl Urol 2019;8(3):228.Google Scholar
Bustos, SS, Bustos, VP, Mascaro, A, et al. Complications and patient-reported outcomes in transfemale vaginoplasty: an updated systematic review and meta-analysis. Plast Reconstr Surg Glob Open 2021;9(3):e3510.Google Scholar
Kanthabalan, A, Jervis, HF, Dusoye, A, et al. PROGRESS (Patient Reported Outcomes in Genital Reconstructive Surgeries): a validated patient reported outcome measure questionnaire to assess post-operative functional improvement following feminising genital reconstructive surgery. Eur Urol 2021;79:S1584–S1584.CrossRefGoogle Scholar
Cardinali, J, Manzer, D. The role of physical therapy in the care of transgender patients. In D. Nikolavsky & S. A. Blakely (Eds.), Urological Care for the Transgender Patient. Cham: Springer, 2021, pp. 219–226.Google Scholar
Bellringer, J. Consultant Urologist and head of Gender Surgery Services Parkside Hospital 2021, personal communication, January 2021.Google Scholar
Buncamper, ME, van der Sluis, WB, van der Pas, RS, et al. Surgical outcome after penile inversion vaginoplasty: a retrospective study of 475 transgender women. Plastic Reconstr Surg 2016;138(5):999–1007.Google Scholar
Jin, B, Turner, L, Walters, WA, Handelsman, DJ. The effects of chronic high dose androgen or estrogen treatment on the human prostate. J Clin Endocrinol Metab 1996;81(12):4290–4295.Google Scholar
Abelson, B, Sun, D, Que, L, et al. Sex differences in lower urinary tract biology and physiology. Biol Sex Differ 2018;9(1):1–3.Google Scholar
Thom, DH, Brown, JS. Reproductive and hormonal risk factors for urinary incontinence in later life: a review of the clinical and epidemiologic literature. J Am Geriatr Soc 1998;46(11):1411–1417.Google ScholarPubMed
Matsuo, K, Ichihara, K, Gotoh, M, Masumori, N. Comparison of the uroflowmetry parameter results between transgender males undergoing gender-affirming hormone therapy and age-matched cisgender females: preliminary data. Transgend Health 2019;4(1):152–156.CrossRefGoogle ScholarPubMed
Fitzpatrick, C, Swierzewski, SJ III, McGuire, EJ. Periurethral collagen for urinary incontinence after gender reassignment surgery. Urology 1993;42(4):458–460.Google Scholar
Brown, JS, Grady, D, Ouslander, JG, et al. Prevalence of urinary incontinence and associated risk factors in postmenopausal women. Obstet Gynecol 1999;94(1):66–70.Google Scholar
Melloni, C, Melloni, G, Rossi, M, et al. Lower urinary tract symptoms in male-to-female transsexuals: short terms results and proposal of a new questionnaire. Plastic Reconstr Surg Global Open 2016;4(3):e655.Google Scholar
Wu, JM, Matthews, CA, Conover, MM, Pate, V, Funk, MJ. Lifetime risk of stress incontinence or pelvic organ prolapse surgery. Obstet Gynecol 2014;123(6):1201.CrossRefGoogle ScholarPubMed
Dietz, HP. The aetiology of prolapse. Int Urogynecol J 2008;19(10):1323.Google Scholar
Bucci, S, Mazzon, G, Liguori, G, et al. Neovaginal prolapse in male-to-female transsexuals: an 18-year-long experience. BioMed Res Int 2014;2014:240761. https://doi.org/10.1155/2014/240761Google Scholar
Parisi, S, Novelli, A, Olearo, E, Basile, A, Puppo, A. Traditional McCall culdoplasty compared to a modified McCall technique with double ligament suspension: anatomical and clinical outcomes. Int Urogynecol J 2020;31(10):2147–2153.CrossRefGoogle ScholarPubMed
Kuhn, A, Santi, A, Birkhäuser, M. Vaginal prolapse, pelvic floor function, and related symptoms 16 years after sex reassignment surgery in transsexuals. Fertil Steril 2011;95(7):2379–2382.CrossRefGoogle ScholarPubMed
Casali, TG, de Castro Paiva, KC, Rodrigues, MN, et al. Topical estradiol increases epidermal thickness and dermal collagen of foreskin prior to hypospadia surgery: randomized double blinded controlled trial. J Pediatr Urol 2019;15(4):346–352.Google Scholar
Pierpont, YN, Dinh, TP, Salas, RE, et al. Obesity and surgical wound healing: a current review. ISRN Obes 2014;2014:638936. https://doi.org/10.1155/2014/638936Google Scholar
Goddard, JC, Vickery, RM, Qureshi, A, et al. Feminizing genitoplasty in adult transsexuals: early and long‐term surgical results. BJU Int 2007;100(3):607–613.Google Scholar
Stanojevic, DS, Djordjevic, ML, Milosevic, A, et al. Sacrospinous ligament fixation for neovaginal prolapse prevention in male-to-female surgery. Urology 2007;70(4):767–771.CrossRefGoogle ScholarPubMed
Persu, C, Chapple, CR, Cauni, V, Gutue, S, Geavlete, P. Pelvic Organ Prolapse Quantification System (POP–Q): a new era in pelvic prolapse staging. J Med Life 2011;4(1):75.Google Scholar
Wallace, SL, Miller, LD, Mishra, K. Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women. Curr Opin Obstet Gynecol 2019;31(6):485–493.Google Scholar
Frederick, RW, Leach, GE. Abdominal sacral colpopexy for repair of neovaginal prolapse in male-to-female transsexuals. Urology 2004;64(3):580–581.Google Scholar

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