Pelvic Floor Physical Therapy vs Standard Care in Transgender Women Undergoing Vaginoplasty for Gender Affirmation

"Patients will present to see the physical therapist 3 weeks and 6 weeks postoperatively. The following interventions will be performed:~3 weeks:~* Subjective assessment of bowel and bladder function~* Visual and external palpation and assessment of external pelvic floor region~* Intravaginal pelvic floor assessment~* Pelvic floor muscle dynamics and coordination assessment~* Instruction of pelvic floor coordination and lengthening~* Discussion of dilator program and progression~* Home program with instructions~ 6 weeks:~* External scar assessment and treatment if tissue healing allows~* Instruction to patient of scar mobilizations~* Intravaginal pelvic floor assessment and treatment if indicated~* Review of pelvic floor lengthening and coordination~* Review and progression of dilator program if appropriate~* Assessment of current bowel/bladder symptoms; home program and instructions to address these symptoms"

"Patients will present to see the physical therapist 3 weeks postoperatively. The following interventions will be performed:~Subjective assessment of bowel and bladder function. Visual and external palpation and assessment of external pelvic floor region. Intravaginal pelvic floor assessment. Pelvic floor muscle dynamics and coordination assessment. Review of pelvic floor anatomy and function."

Preoperative Diaphragmatic breathing Discuss dilator positioning/introduce dilator program External pelvic floor assessment Teach pelvic floor coordination Current bowel/bladder symptoms; home program and instructions 3 weeks Assessment of bowel and bladder function Visual and external palpation and assessment of external pelvic floor region Intravaginal pelvic floor assessment Pelvic floor muscle dynamics and coordination assessment Instruction of pelvic floor coordination and lengthening Discussion of dilator program and progression Home program with instructions 6 weeks External scar assessment and treatment if tissue healing allows Instruction to patient of scar mobilizations Intravaginal pelvic floor assessment and treatment if indicated Review of pelvic floor lengthening and coordination Review and progression of dilator program if appropriate Current symptoms; home program and instructions