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Vaginoplasty can worsen overactive bladder (OAB) symptoms and reduce quality of life in transgender women, particularly in older patients and those receiving peritoneal flap vaginoplasty (PFV). The overall impact on OAB symptoms appears limited.

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Area of Science:

  • Urology
  • Gender-affirming surgery
  • Patient-reported outcomes

Background:

  • Overactive bladder (OAB) is a condition characterized by urinary urgency, often with frequency and nocturia.
  • Vaginoplasty is a key component of gender-affirming surgery for transgender women.
  • The impact of vaginoplasty on pre-existing OAB symptoms requires further investigation.

Purpose of the Study:

  • To evaluate changes in overactive bladder symptoms following vaginoplasty in transgender women.
  • To identify potential risk factors associated with worsened OAB symptoms post-surgery.

Main Methods:

  • Retrospective longitudinal study of 53 transgender women undergoing vaginoplasty.
  • Utilized the Overactive Bladder Questionnaire Short-Form (OAB-q SF) pre- and post-surgery.
  • Analyzed changes in Symptom Bother and Health-Related Quality of Life (HRQL) scores, stratified by age and vaginoplasty type.

Main Results:

  • A statistically significant decline in HRQL was observed post-vaginoplasty (p=0.020).
  • Older patients (44-71 years) experienced the most significant worsening of Symptom Bother (p=0.020) and HRQL (p=0.008).
  • Peritoneal flap vaginoplasty (PFV) was associated with a significant decrease in HRQL (p=0.023).

Conclusions:

  • Vaginoplasty can lead to increased OAB symptoms and reduced quality of life in transgender women.
  • Older age and PFV are identified as risk factors for symptom exacerbation.
  • The clinical significance of these changes warrants further study, as overall effects may be limited.