title: Vaginal prolapse, pelvic floor function, and related symptoms 16 years after sex reassignment surgery in transsexuals.
abstract: OBJECTIVE
  To evaluate the prevalence of prolapse and related bladder, bowel, and sexual problems in transsexual patients (TS) after sex reassignment surgery.
  
  
  METHODS
  A cross-sectional study.
  
  
  METHODS
  A tertiary referral center.
  
  
  METHODS
  55 transsexuals, comprising 52 male-to-female and 3 female-to-male patients.
  
  
  METHODS
  Gynecologic examination with pelvic floor testing, measurements for pelvic organ prolapse applying International Continence Society pelvic organ prolapse (ICS-POP) staging, and the Sheffield prolapse questionnaire to assess prolapse symptoms, and bladder, bowel, and sexual function.
  
  
  METHODS
  ICS-POP score and Sheffield prolapse questionnaire.
  
  
  RESULTS
  Of the 55 transsexuals who participated in this study (52 male-to-female and 3 female to male), 7.5% showed a prolapse greater than or similar to ICS-POP stage 2, and 3.8% required surgical intervention. For bladder symptoms, 47% reported voiding difficulties, 24.6% urgency, 17% urge incontinence, and 23% stress incontinence. Fecal urgency and incomplete emptying of the bowel occurred in 9.4% and 7.6% of patients, respectively. In addition, 23% reported that they were never satisfied with their sexual function.
  
  
  CONCLUSIONS
  Pelvic floor symptoms may occur in transsexuals involving the bladder, bowel, and sexual function. Surgical corrective options should be determined on an individual basis as with other patients who have prolapse symptoms.
authors: Frauenklinik, University Hospital and University of Berne, Berne, Switzerland. anette.kuhn@insel.ch
authors: Annette
authors: A
authors: Kuhn
authors: Alessandro
authors: A
authors: Santi
authors: Martin
authors: M
authors: Birkhäuser
mesh_terms: D003430:Cross-Sectional Studies; D003672:Defecation; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D017773:Pelvic Floor / Q000503:physiopathology* / Q000601:surgery; D015995:Prevalence; D012086:Reoperation; D057830:Gender-Affirming Surgery / Q000009:adverse effects*; D012735:Sexual Dysfunction, Physiological / Q000209:etiology / Q000503:physiopathology; D011795:Surveys and Questionnaires; D013557:Switzerland; D013997:Time Factors; D014189:Transsexualism / Q000601:surgery*; D016896:Treatment Outcome; D001745:Urinary Bladder Diseases / Q000209:etiology / Q000503:physiopathology; D014555:Urination Disorders / Q000209:etiology / Q000503:physiopathology; D014596:Uterine Prolapse / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery