MP31-20 URINARY INCONTINENCE AND QUALITY OF LIFE IN FEMALE-TO-MALE TRANSGENDER SUBJECTS ON HORMONE THERAPY

Abstract

INTRODUCTION AND OBJECTIVE: To investigate whether lower urinary tract symptoms (LUTS) impact quality of life (QOL) in female-to-male transgender persons on chronic testosterone therapy. Secondarily, we aimed to identify patient-related physical and social factors that contribute to differences in QOL. METHODS: Transgender female-to-male subjects, 18 years or older, treated with testosterone for at least 12 months were recruited from a public health care system. Subjects were excluded if they had prior surgery for incontinence, pelvic organ prolapse, or gender affirmation or an active urinary tract infection. LUTS were assessed using the American Urologic Association Symptom Score (AUASS) and the International Consultation on Incontinence Questionnaire (ICIQ). The WHOQOL-BREF instrument was used to investigate QOL, and the CES-D 8 instrument was used to screen for depression. T-test and Chi-square were used to compare continuous and categorical variables, respectively. The relationship between patient factors and QOL was evaluated using multivariable logistic regression. RESULTS: Overall, 141 transmen were included in the study. Subjects were subdivided into two cohorts based on presence of urinary incontinence defined by the ICIQ score. In the incontinence group [n=49, (34.8%)], individuals were older [30.6 vs 26.2 years, p [0.01], had a higher body mass index (BMI) [p=0.015], and cigarette smoking history [p=0.01] compared to those without incontinence [n=92 (65.2%)]. The incontinence group had a higher prevalence of positive screening for depression [63.3 vs 39.1%, p=0.006] and were more frequently classified as having a poor QOL index [20.4 vs 3.3%, p=0.0008]. On multivariate analysis, limited medical transportation [aOR: 0.23, CI: 0.06-0.91], lack of money for food [aOR: 0.23, CI: 0.07- 0.90], and increased BMI [aOR: 0.92, CI: 0.86-0.99] were factors influencing poor QOL. CONCLUSIONS: Presence of incontinence in female-to-male transgender persons is associated with increased age, higher BMI, and smoking history. Despite these findings, presence of LUTS was not found to be independently associated with QOL after adjusting for psychosocial factors. (Figure Presented).