Sexual function and voiding status following one stage feminizing genitoplasty

Area of Science:

• Pediatric Surgery
• Urology
• Gynecology
• Sexual Medicine

Background:

• Limited data exists on long-term sexual function and voiding after feminizing genitoplasty (FG).
• Previous studies often focused on cosmetic outcomes, neglecting crucial aspects of sexual health.
• Evaluating sexual function, including sensation, satisfaction, and intercourse comfort, is essential for comprehensive success assessment.

Purpose of the Study:

• To assess long-term sexual function and voiding status in women who underwent childhood feminizing genitoplasty (FG).

Main Methods:

• Retrospective review of medical records for patients who underwent FG between 1988 and 2000.
• Standardized questionnaires administered: Female Genital Self-Image Scale (FGSIS), dysfunctional voiding and incontinence symptoms score (DVISS), and Female Sexual Function Questionnaire (FSFI).

Main Results:

• 36 patients (median age 21) completed puberty and were included; 80% engaged in regular sexual intercourse.
• Overall Female Sexual Function Questionnaire (FSFI) score was 22.2, with positive scores across all domains except mild dyspareunia in one patient.
• No patients reported daytime incontinence or enuresis; positive genital self-image correlated with better sexual function.

Conclusions:

• One-stage feminizing genitoplasty (FG) is an effective long-term procedure with no significant impact on voiding function.
• While overall sexual function is acceptable, mild dyspareunia was the main complaint.
• Secondary interventions like introitoplasty can successfully address issues arising before sexual activity.