Evaluation of Lower Urinary Tract Function After Surgery

Abstract

The current chapter discusses the evaluation of lower urinary tract function after surgery. It is well known that sex reassignment surgery is considered to be the gold standard in the treatment of gender dysphoria. In this context, the surgical approach of male-to-female transsexuals (MTF) is the resection of the penis shaft and the removal of the testes allowing the use of the penile and scrotum skin to create a neovagina while the urethra is shortened and the prostate stays in situ. Therefore, from a functional point of view, this surgical technique, not involving the sphincter complex in its proximal and distal component, should not lead to problems concerning urinary continence, while conversely, a reduction of the total length of the urethra should lead to a reduction of the resistance to urine flow with a consequent decrease in the total time needed to empty the bladder. In this chapter, therefore, we cannot avoid dealing with some aspects about the pathophysiology of continence that will allow us to make a reasoned assessment of the useful path leading to the identification of a possible diagnostic algorithm in these patients. (PsycINFO Database Record (c) 2016 APA, all rights reserved)