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Introduction and Hypothesis <p>There are scant pooled data on transgender individuals regarding pelvic floor dysfunction, with or without gender-affirming surgery (GAS).</p> Methods <p>A scoping review following PRISMA-ScR guidelines was carried out using PubMed, EMBASE, Scopus, Web of Science, Cochrane Library, and Lilacs in June 2024. The following pelvic floor disorders were investigated: urinary and anorectal dysfunctions, pelvic organ prolapse (POP), sexual dysfunction and pelvic floor disorders after GAS.</p> Results <p>Of 1284 studies, 35 remained for full-text analysis and data extraction. Urinary dysfunction was seen within 10 studies and prevalence of urinary incontinence (UI) varied from 15.4 to 53%, with age, BMI, and depression identified as factors in these studies. Anorectal dysfunction was found in four studies and constipation was the most frequent complaint, varying from 22 to 45%. Constipation was the main anorectal complaint (22%–45.6%). POP rate after neovaginoplasty ranged between 4% and 7.5%. Regarding sexual dysfunction, the Female Sexual Function Index, was the most commonly used questionnaire. Sexual desire appears to be affected by gender-affirming hormone therapy, whereas lubrication and pain were altered in trans women (TW) patients. Sexual dysfunction rates in trans men (TM) were high (54%–87.8%). Regarding complications, most common findings were vaginal stenosis in TW and urethral strictures and fistulas in TM.</p> Conclusion <p>There is a high prevalence of pelvic floor dysfunction among the transgender population. Future cohort studies with better defined instruments and standardized pelvic examinations are recommended.</p>

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Pelvic Floor Dysfunction in the Transgender Patient: A Scoping Review

  • 期刊论文

  • 发表日期：

    2025年10月13日

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  • Livia Maria de Souza Santos Hatanaka,
  • Glaucia Miranda Varella Pereira,
  • Lucia Alves da Silva Lara,
  • Cristine Homsi Jorge,
  • Cassia Raquel Teatin Juliato,
  • Luiz Gustavo Oliveira Brito

摘要

Introduction and Hypothesis

There are scant pooled data on transgender individuals regarding pelvic floor dysfunction, with or without gender-affirming surgery (GAS).

Methods

A scoping review following PRISMA-ScR guidelines was carried out using PubMed, EMBASE, Scopus, Web of Science, Cochrane Library, and Lilacs in June 2024. The following pelvic floor disorders were investigated: urinary and anorectal dysfunctions, pelvic organ prolapse (POP), sexual dysfunction and pelvic floor disorders after GAS.

Results

Of 1284 studies, 35 remained for full-text analysis and data extraction. Urinary dysfunction was seen within 10 studies and prevalence of urinary incontinence (UI) varied from 15.4 to 53%, with age, BMI, and depression identified as factors in these studies. Anorectal dysfunction was found in four studies and constipation was the most frequent complaint, varying from 22 to 45%. Constipation was the main anorectal complaint (22%–45.6%). POP rate after neovaginoplasty ranged between 4% and 7.5%. Regarding sexual dysfunction, the Female Sexual Function Index, was the most commonly used questionnaire. Sexual desire appears to be affected by gender-affirming hormone therapy, whereas lubrication and pain were altered in trans women (TW) patients. Sexual dysfunction rates in trans men (TM) were high (54%–87.8%). Regarding complications, most common findings were vaginal stenosis in TW and urethral strictures and fistulas in TM.

Conclusion

There is a high prevalence of pelvic floor dysfunction among the transgender population. Future cohort studies with better defined instruments and standardized pelvic examinations are recommended.