{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T01:52:44Z","timestamp":1784857964817,"version":"3.55.0"},"reference-count":31,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,8,6]],"date-time":"2024-08-06T00:00:00Z","timestamp":1722902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Gender\u2010affirming genital surgery is one of several surgical procedures available to transgender and nonbinary (TGNB) individuals to improve congruence between their gender identity and sex assigned at birth. Despite increasing utilization of these procedures, patient\u2010reported outcome measures (PROMs) to assess subjective outcomes following gender\u2010affirming genital surgery remain limited. Our aim was to provide a synopsis of PROMs currently being used to evaluate urinary outcomes among TGNB patients following gender\u2010affirming genital surgery and to assess each PROM for content that is relevant to TGNB patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A multidatabase search was performed (Embase and PubMed) using search terms that included <jats:italic>transgender<\/jats:italic>, <jats:italic>patient\u2010reported outcome measures, questionnaire, and gender\u2010affirming surgery.<\/jats:italic> Studies that assessed subjective outcomes related to urinary outcomes and pelvic floor dysfunction following gender\u2010affirming genital surgery were reviewed. Gender\u2010affirming genital surgery included vaginal reconstruction (vaginoplasty) and penile reconstruction (phalloplasty and metoidioplasty). Included studies were evaluated for relevant content items and summarized in table.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our literature search identified 820 unique articles. Twenty\u2010seven full articles were included in the final review. Until recently, measurement tools have been limited to unvalidated ad hoc questionnaires or PROMs developed for other conditions, such as urinary incontinence or vaginal prolapse, that are validated among the predominantly cisgender general population. Of the selected studies, PROMs used to evaluate urinary and pelvic floor dysfunction following gender\u2010affirming genital surgery included self\u2010construced ad hoc questionnaires (10 studies), Amsterdam Overactive Pelvic Floor Scale (four studies), King's Health Questionnaire (two studies), Pelvic Floor Distress Inventory (PFDI)\u221220 (two studies), Sheffield Pelvic Organ Prolapse (one study), International Consultation on Incontinence Questionnaire\u2010Urinary Incontinence (ICIQ\u2010UI) (one study), and ICIQ\u2010Female Lower Urinary Tract Symptoms (one study). The PFDI\u201020 asked about the most relevant symptoms to TGNB patients following genital surgery; however, not all cisgender validated questionnaires included important questions about voiding position, splayed or misdirected stream. The Affirming Surgery Form and Function Individual Reporting Measure (AFFIRM) questionnaire is the first PROM for assessing subjective urinary outcomes that are validated for TGNB individuals, and the GENDER\u2010Q is a promising new PROM with the aim of evaluating outcomes following surgical and other gender\u2010affirming treatments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Despite recent advancements, a need remains for standardized assessment tools to evaluate pelvic floor dysfunction and urinary symptoms following gender\u2010affirming genital surgery. Questionnaires developed for the general population to assess symptoms of pelvic organ prolapse and other urinary dysfunction do not fully capture the experiences unique to TGNB individuals undergoing this type of surgery. Nonetheless, PROMs validated specifically for TGNB individuals are necessary to more accurately evaluate outcomes of gender\u2010affirming genital surgery, allow for informed patient counseling, and create evidence\u2010based changes to improve these interventions.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.25561","type":"journal-article","created":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T02:55:03Z","timestamp":1722999303000},"page":"2110-2122","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Patient\u2010reported outcome measures for assessing urinary dysfunction following gender\u2010affirming genital surgery: A narrative review of the literature"],"prefix":"10.1002","volume":"43","author":[{"given":"Cathrine","family":"Keiner","sequence":"first","affiliation":[{"name":"Department of Urology UC San Diego Health La Jolla California USA"},{"name":"Department of Urology University of Minnesota Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyle","family":"Okamuro","sequence":"additional","affiliation":[{"name":"Department of Urology UC San Diego Health La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taylor","family":"Bate","sequence":"additional","affiliation":[{"name":"Department of Urology UC San Diego Health La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geolani","family":"Dy","sequence":"additional","affiliation":[{"name":"Department of Urology Oregon Health &amp; Science University Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7688-4688","authenticated-orcid":false,"given":"Jennifer","family":"Anger","sequence":"additional","affiliation":[{"name":"Department of Urology UC San Diego Health La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,6]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2004.10.008"},{"issue":"4","key":"e_1_2_9_3_1","first-page":"121","article-title":"Urinary complications after penile inversion vaginoplasty in transgender women systematic review and meta\u2010analysis","volume":"17","author":"Ding C","year":"2023","journal-title":"Can Urol Assoc J"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000001131"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.21037\/tau-22-675"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00266-017-0812-4"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.21037\/tau.2019.05.04"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000004254"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004717"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsxm.2016.06.009"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jsm.12914"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsxm.2021.03.002"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsxm.2016.12.205"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.24728"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000002141"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-025435"},{"key":"e_1_2_9_17_1","first-page":"37","article-title":"Patient reported outcomes after metoidioplasty","volume":"12","author":"Kuehhas F","year":"2015","journal-title":"J\u00a0Sexu\u00a0Med"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2008.08.126"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2006.03.019"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2011.03.029"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10508-006-9104-9"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000001680"},{"key":"e_1_2_9_23_1","unstructured":"MelloniC MelloniG CarmiscianoM et al. 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