We used a validated urinary questionnaire, the OAB Questionnaire Short-Form (OAB-q SF), to assess changes before and after surgery. Based on our hypothesis that the pelvic dissection of certain vaginoplasty techniques would impact urinary symptoms, we also performed subgroup analysis by type of vaginoplasty performed.
Our findings demonstrated that there was a statistically significant decline in Health-related Quality of Life (HRQL) for all patients. On subgroup analysis, patients who underwent peritoneal flap vaginoplasty also had a significant decline in HRQL, which may be attributable to manipulation of the peritoneum overlying the posterior bladder wall. The oldest quartile of patients had statistically significant declines in Symptom Bother and HRQL, possibly due to comorbid conditions, such as diabetes or benign prostatic hyperplasia, that would exacerbate OAB symptoms.
Despite the statistical significance of our results, the clinical significance of OAB-q SF declines remains unclear. The magnitude of the changes did not meet a previously published minimally important difference threshold for the OAB-q SF, which suggests that the overall effects of vaginoplasty on OAB symptoms are limited. Further prospective study with long-term follow-up can elucidate surgical and patient risk factors for better patient selection, counseling, and surgical decision-making.
Written by: Patrick Ho,1 Camille Torres,1 Francisco Andrade,2 Michael Palese,1 Miroslav Djordjevic,3 Rajveer S. Purohit1
- Department of Urology, Mount Sinai Hospital, New York, NY.
- State University of New York Downstate Health Sciences University, Brooklyn, NY.
- University of Belgrade Department of Surgery and Urology, Belgrade, Serbia.