Voiding Dysfunction in Transgender Patients: What We Know and What We Do Not Know.

Area of Science:

• Urology
• Gender-affirming care
• Surgical outcomes

Background:

• Transgender and non-binary (TGNB) individuals undergoing gender-affirming genital surgery can experience perioperative voiding dysfunction.
• Understanding these urinary complications is crucial for patient care.

Purpose of the Study:

• To review and analyze existing literature on urinary complications following gender-affirming pelvic surgery.
• To outline current evaluation and treatment strategies for voiding dysfunction in TGNB patients.

Main Methods:

• Literature review of studies on gender-affirming genital surgery and urinary outcomes.
• Analysis of reported complications, diagnostic approaches, and management options.

Main Results:

• Pre-operative discussion of urinary goals and symptoms is vital due to variable post-operative outcomes.
• Gender-affirming hormone therapy can impact urinary symptoms.
• Urethral strictures and urethrocutaneous fistulae are potential complications manifesting as lower urinary tract symptoms (LUTS).
• No standardized approach exists for managing post-operative voiding issues, but options are available.
• Patient evaluation should be affirming and personalized.
• Long-term outcome data and validated questionnaires for TGNB patients are needed.

Conclusions:

• Voiding dysfunction is a significant concern after gender-affirming genital surgery.
• Further research and standardized outcome measures are necessary to improve care for TGNB patients.