Indications for the Utilization of Pelvic Floor Physical Therapy for Transgender Women Following Gender-Affirming Vaginoplasty: A Narrative Review.

PURPOSE: The rate is on the rise of transgender women choosing to have a gender-affirming vaginoplasty in the United States of America, and little is documented on postoperative recommendations to decrease complications and maximize function. This review aimed to identify the indications to incorporate pelvic floor physical therapy into the process for transgender women completing a gender-affirming vaginoplasty.

METHODS

Articles were gathered from CINAHL, SPORTDiscus, PubMed, and MEDLINE with keywords including "transgender," "transsexual," "gender affirmation surgery," "sex reassignment," "pelvic floor," "physical therapy," "male-to-female," and "complications." A total of 13 sources were found to be relevant to this study and included in the review.

RESULTS

Results from this literature review found that transgender women frequently have complications of urinary incontinence, prolonged pelvic pain, and neovaginal stenosis after completing vaginoplasty surgery. A case study and two retrospective studies demonstrated positive outcomes from physical therapy related to pelvic pain, dilation protocol, and urinary and bowel function.

CONCLUSIONS

Minimal research shows positive outcomes following pelvic floor physical therapy program for transgender women following gender-affirming vaginoplasty. However, no true conclusions can be drawn due to lack of research comparing pelvic floor physical therapy following gender-affirming vaginoplasty with a control.