<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03293771</url>
  </required_header>
  <id_info>
    <org_study_id>1708018495</org_study_id>
    <nct_id>NCT03293771</nct_id>
  </id_info>
  <brief_title>Transgender Post-reassignment Urogynecologic Measures and Perceptions</brief_title>
  <official_title>Assessment of Postoperative Urologic and Pelvic Floor Complaints in Male-to-female Transgender Patients: a Mixed Methods Study</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Weill Medical College of Cornell University</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
    <collaborator>
      <agency>Icahn School of Medicine at Mount Sinai</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>The Cleveland Clinic</agency>
      <agency_class>Other</agency_class>
    </collaborator>
    <collaborator>
      <agency>Boston Medical Center</agency>
      <agency_class>Other</agency_class>
    </collaborator>
  </sponsors>
  <source>Weill Medical College of Cornell University</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      The intent of this mixed methods study for transgender women after gender confirmation&#xD;
      surgery is to characterize and subsequently create a validated screening questionnaire for&#xD;
      postoperative urologic and pelvic floor symptoms. For individuals who seek gender-confirming&#xD;
      treatment, about 13% undergo genital surgery for cosmetic purposes with or without&#xD;
      gonadectomy, and this number is increasing. Patient satisfaction following surgery is high,&#xD;
      particularly regarding sexual and cosmetic outcomes; however, unexpected negative functional&#xD;
      outcomes such as bowel and bladder dysfunction and pelvic organ prolapse impact overall&#xD;
      patient satisfaction. The available information suggests that 16-33% of patients experience&#xD;
      incontinence postoperatively, with stress predominance, 32-47% experience abnormal voiding,&#xD;
      and 24-66% experience overactive bladder symptoms. Outside of the typically assessed voiding&#xD;
      symptoms, unique complaints of MTF postoperative patients include obstructive voiding&#xD;
      symptoms due to urethral stenosis, persistent perimeatal erectile tissue, prostatic&#xD;
      hypertrophy, and irritation from neovaginal tissue. Additionally, may of these patients&#xD;
      develop symptomatic neovaginal prolapse, requiring re-suspension. We suggest that further&#xD;
      clarification regarding MTF postoperative urologic and pelvic floor complaints can be&#xD;
      achieved via a mixed methods approach. By using focus group interviews to create specific&#xD;
      evaluative questions for this unique population, we can then prospectively assess patients&#xD;
      undergoing surgery via a national multicenter sampling strategy. The goal of the study is to&#xD;
      better understand the unique symptoms these women experience and create a validated, reliable&#xD;
      screening questionnaire to monitor patients after surgery.&#xD;
    </textblock>
  </brief_summary>
  <overall_status>Unknown status</overall_status>
  <last_known_status>Recruiting</last_known_status>
  <start_date type="Actual">December 27, 2017</start_date>
  <completion_date type="Anticipated">December 31, 2019</completion_date>
  <primary_completion_date type="Anticipated">December 31, 2019</primary_completion_date>
  <study_type>Observational [Patient Registry]</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <observational_model>Other</observational_model>
    <time_perspective>Other</time_perspective>
  </study_design_info>
  <target_duration>6 Weeks</target_duration>
  <primary_outcome>
    <measure>Stage 1: Focus groups</measure>
    <time_frame>3 months</time_frame>
    <description>Characterization of genital, urologic, bowel, and sexual symptoms following male-to-female gender confirmation surgery</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Stage 2: Questionnaire testing</measure>
    <time_frame>12 months</time_frame>
    <description>Validity and reliability testing of new questionnaire</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Frequency and severity of symptoms</measure>
    <time_frame>15 months</time_frame>
    <description>Frequency and severity of symptoms</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Relationship between surgical technique and symptoms</measure>
    <time_frame>15 months</time_frame>
    <description>Relationship between surgical technique and symptoms</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Effect of hormonal therapy usage and symptoms</measure>
    <time_frame>15 months</time_frame>
    <description>Effect of hormonal therapy usage and symptoms</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Length of time since surgery and development of symptoms</measure>
    <time_frame>15 months</time_frame>
    <description>Length of time since surgery and development of symptoms</description>
  </secondary_outcome>
  <number_of_groups>2</number_of_groups>
  <enrollment type="Anticipated">200</enrollment>
  <condition>Gender Identity Disorder of Adult</condition>
  <condition>Voiding Disorders</condition>
  <condition>Sexual Dysfunction</condition>
  <arm_group>
    <arm_group_label>Stage 1 Focus Groups</arm_group_label>
    <description>The focus groups will involve transgender women who have completed gender confirmation surgery who volunteer to discuss their postoperative experience regarding bladder function, genital complaints, and sexual function.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Stage 2 Questionnaire Groups</arm_group_label>
    <description>Stage 2 participants will be asked to complete a questionnaire packet after surgery followed by a second questionnaire completion 2 weeks later. Participants' operative notes and postoperative visit records will be reviewed.</description>
  </arm_group>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>Focus group interviews</intervention_name>
    <description>Focus group participants will be asked about their postoperative urogynecologic experience. Confidentiality will be enforced and participants will be made aware that they may opt out of answering any questions.</description>
    <arm_group_label>Stage 1 Focus Groups</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Diagnostic Test</intervention_type>
    <intervention_name>Questionnaire packet</intervention_name>
    <description>Participants will be asked to complete a questionnaire packet comprised of three previously validated questionnaires and one newly created focused questionnaire. They will be asked to complete the new questionnaire again 2 weeks later. We estimate about 10 minutes will be required to complete the packet.</description>
    <arm_group_label>Stage 2 Questionnaire Groups</arm_group_label>
  </intervention>
  <eligibility>
    <study_pop>
      <textblock>
        Stage 1 (Focus group) participants will be comprised of healthy volunteers from the&#xD;
        transgender community who have completed male-to-female gender confirmation surgery. They&#xD;
        will be recruited through local clinics, physician referral, or community support groups.&#xD;
&#xD;
        Stage 2 (Questionnaire) participants will be recruited through multiple transgender centers&#xD;
        at time of surgical scheduling or within 4 weeks after male-to-female gender confirmation&#xD;
        surgery.&#xD;
      </textblock>
    </study_pop>
    <sampling_method>Non-Probability Sample</sampling_method>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Stage 1 -- Male-to-female transgender women who are at least 4 weeks postoperative&#xD;
             following genital surgery for gender confirmation&#xD;
&#xD;
          -  Stage 2 -- Male-to-female transgender women who are scheduled to undergo surgery or&#xD;
             are within 4 weeks postoperative&#xD;
&#xD;
          -  Both stages -- Minimum age 18 years old&#xD;
&#xD;
          -  Both stages -- English fluency&#xD;
&#xD;
          -  Both stages -- Reliable contact information and/or permanent residence&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Preexisting pelvic pathology, including abnormal anatomy or baseline voiding&#xD;
             dysfunction&#xD;
&#xD;
          -  Urinary or intestinal problems prior to surgery lasting greater than 6 weeks&#xD;
      </textblock>
    </criteria>
    <gender>Male</gender>
    <gender_based>Yes</gender_based>
    <gender_description>Study participants involve transgender individuals who were born phenotypically male but identify as female.</gender_description>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Sarah Huber, MD</last_name>
    <role>Principal Investigator</role>
    <affiliation>Weill Medical College of Cornell University</affiliation>
  </overall_official>
  <overall_contact>
    <last_name>Sarah Huber, MD</last_name>
    <phone>212-746-5352</phone>
    <email>sah2757@med.cornell.edu</email>
  </overall_contact>
  <location>
    <facility>
      <name>Weill Cornell Medicine</name>
      <address>
        <city>New York</city>
        <state>New York</state>
        <zip>10065</zip>
        <country>United States</country>
      </address>
    </facility>
    <status>Recruiting</status>
    <contact>
      <last_name>Sarah Huber, MD</last_name>
      <phone>212-746-5352</phone>
      <email>sah2757@med.cornell.edu</email>
    </contact>
  </location>
  <location_countries>
    <country>United States</country>
  </location_countries>
  <reference>
    <citation>Selvaggi G, Bellringer J. Gender reassignment surgery: an overview. Nat Rev Urol. 2011 May;8(5):274-82. doi: 10.1038/nrurol.2011.46. Epub 2011 Apr 12.</citation>
    <PMID>21487386</PMID>
  </reference>
  <reference>
    <citation>Clements-Nolle K, Marx R, Katz M. Attempted suicide among transgender persons: The influence of gender-based discrimination and victimization. J Homosex. 2006;51(3):53-69. doi: 10.1300/J082v51n03_04.</citation>
    <PMID>17135115</PMID>
  </reference>
  <reference>
    <citation>Kailas M, Lu HMS, Rothman EF, Safer JD. PREVALENCE AND TYPES OF GENDER-AFFIRMING SURGERY AMONG A SAMPLE OF TRANSGENDER ENDOCRINOLOGY PATIENTS PRIOR TO STATE EXPANSION OF INSURANCE COVERAGE. Endocr Pract. 2017 Jul;23(7):780-786. doi: 10.4158/EP161727.OR. Epub 2017 Apr 27.</citation>
    <PMID>28448757</PMID>
  </reference>
  <reference>
    <citation>Revol M, Servant JM, Banzet P. [Surgical treatment of male-to-female transsexuals: a ten-year experience assessment]. Ann Chir Plast Esthet. 2006 Dec;51(6):499-511. doi: 10.1016/j.anplas.2006.02.006. Epub 2006 Apr 19. French.</citation>
    <PMID>16626849</PMID>
  </reference>
  <reference>
    <citation>Hess J, Rossi Neto R, Panic L, Rubben H, Senf W. Satisfaction with male-to-female gender reassignment surgery. Dtsch Arztebl Int. 2014 Nov 21;111(47):795-801. doi: 10.3238/arztebl.2014.0795.</citation>
    <PMID>25487762</PMID>
  </reference>
  <reference>
    <citation>Goddard JC, Vickery RM, Qureshi A, Summerton DJ, Khoosal D, Terry TR. Feminizing genitoplasty in adult transsexuals: early and long-term surgical results. BJU Int. 2007 Sep;100(3):607-13. doi: 10.1111/j.1464-410X.2007.07017.x.</citation>
    <PMID>17669144</PMID>
  </reference>
  <reference>
    <citation>Buncamper ME, van der Sluis WB, van der Pas RSD, Ozer M, Smit JM, Witte BI, Bouman MB, Mullender MG. Surgical Outcome after Penile Inversion Vaginoplasty: A Retrospective Study of 475 Transgender Women. Plast Reconstr Surg. 2016 Nov;138(5):999-1007. doi: 10.1097/PRS.0000000000002684.</citation>
    <PMID>27782992</PMID>
  </reference>
  <reference>
    <citation>Jarolim L, Sedy J, Schmidt M, Nanka O, Foltan R, Kawaciuk I. Gender reassignment surgery in male-to-female transsexualism: A retrospective 3-month follow-up study with anatomical remarks. J Sex Med. 2009 Jun;6(6):1635-1644. doi: 10.1111/j.1743-6109.2009.01245.x. Epub 2009 Mar 30.</citation>
    <PMID>19473463</PMID>
  </reference>
  <reference>
    <citation>Rossi Neto R, Hintz F, Krege S, Rubben H, Vom Dorp F. Gender reassignment surgery--a 13 year review of surgical outcomes. Int Braz J Urol. 2012 Jan-Feb;38(1):97-107. doi: 10.1590/s1677-55382012000100014.</citation>
    <PMID>22397771</PMID>
  </reference>
  <reference>
    <citation>Hoebeke P, Selvaggi G, Ceulemans P, De Cuypere G, T'Sjoen G, Weyers S, Decaestecker K, Monstrey S. Impact of sex reassignment surgery on lower urinary tract function. Eur Urol. 2005 Mar;47(3):398-402. doi: 10.1016/j.eururo.2004.10.008. Epub 2004 Dec 2.</citation>
    <PMID>15716207</PMID>
  </reference>
  <reference>
    <citation>Lawrence AA. Patient-reported complications and functional outcomes of male-to-female sex reassignment surgery. Arch Sex Behav. 2006 Dec;35(6):717-27. doi: 10.1007/s10508-006-9104-9. Epub 2006 Nov 16.</citation>
    <PMID>17109225</PMID>
  </reference>
  <reference>
    <citation>Horbach SE, Bouman MB, Smit JM, Ozer M, Buncamper ME, Mullender MG. Outcome of Vaginoplasty in Male-to-Female Transgenders: A Systematic Review of Surgical Techniques. J Sex Med. 2015 Jun;12(6):1499-512. doi: 10.1111/jsm.12868. Epub 2015 Mar 26.</citation>
    <PMID>25817066</PMID>
  </reference>
  <reference>
    <citation>Kuhn A, Santi A, Birkhauser M. Vaginal prolapse, pelvic floor function, and related symptoms 16 years after sex reassignment surgery in transsexuals. Fertil Steril. 2011 Jun;95(7):2379-82. doi: 10.1016/j.fertnstert.2011.03.029. Epub 2011 Apr 2.</citation>
    <PMID>21458798</PMID>
  </reference>
  <reference>
    <citation>Kuhn A, Hiltebrand R, Birkhauser M. Do transsexuals have micturition disorders? Eur J Obstet Gynecol Reprod Biol. 2007 Apr;131(2):226-30. doi: 10.1016/j.ejogrb.2006.03.019. Epub 2006 May 5.</citation>
    <PMID>16678333</PMID>
  </reference>
  <reference>
    <citation>Dietrich W, Haitel A, Huber JC, Reiter WJ. Expression of estrogen receptors in human corpus cavernosum and male urethra. J Histochem Cytochem. 2004 Mar;52(3):355-60. doi: 10.1177/002215540405200306.</citation>
    <PMID>14966202</PMID>
  </reference>
  <verification_date>April 2019</verification_date>
  <study_first_submitted>September 20, 2017</study_first_submitted>
  <study_first_submitted_qc>September 20, 2017</study_first_submitted_qc>
  <study_first_posted type="Actual">September 26, 2017</study_first_posted>
  <last_update_submitted>April 22, 2019</last_update_submitted>
  <last_update_submitted_qc>April 22, 2019</last_update_submitted_qc>
  <last_update_posted type="Actual">April 23, 2019</last_update_posted>
  <responsible_party>
    <responsible_party_type>Sponsor</responsible_party_type>
  </responsible_party>
  <keyword>Transgender women</keyword>
  <keyword>Male-to-female</keyword>
  <keyword>Gender confirmation surgery</keyword>
  <keyword>Voiding disorder</keyword>
  <keyword>Vaginal dysfunction</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Gender Dysphoria</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>Undecided</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03293771
org study id: 1708018495
nct id: NCT03293771
lead sponsor: 
collaborator: 
collaborator: 
collaborator: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
The intent of this mixed methods study for transgender women after gender confirmation
      surgery is to characterize and subsequently create a validated screening questionnaire for
      postoperative urologic and pelvic floor symptoms. For individuals who seek gender-confirming
      treatment, about 13% undergo genital surgery for cosmetic purposes with or without
      gonadectomy, and this number is increasing. Patient satisfaction following surgery is high,
      particularly regarding sexual and cosmetic outcomes; however, unexpected negative functional
      outcomes such as bowel and bladder dysfunction and pelvic organ prolapse impact overall
      patient satisfaction. The available information suggests that 16-33% of patients experience
      incontinence postoperatively, with stress predominance, 32-47% experience abnormal voiding,
      and 24-66% experience overactive bladder symptoms. Outside of the typically assessed voiding
      symptoms, unique complaints of MTF postoperative patients include obstructive voiding
      symptoms due to urethral stenosis, persistent perimeatal erectile tissue, prostatic
      hypertrophy, and irritation from neovaginal tissue. Additionally, may of these patients
      develop symptomatic neovaginal prolapse, requiring re-suspension. We suggest that further
      clarification regarding MTF postoperative urologic and pelvic floor complaints can be
      achieved via a mixed methods approach. By using focus group interviews to create specific
      evaluative questions for this unique population, we can then prospectively assess patients
      undergoing surgery via a national multicenter sampling strategy. The goal of the study is to
      better understand the unique symptoms these women experience and create a validated, reliable
      screening questionnaire to monitor patients after surgery.
observational model: Other
time perspective: Other
measure: Stage 1: Focus groups
time frame: 3 months
description: Characterization of genital, urologic, bowel, and sexual symptoms following male-to-female gender confirmation surgery
measure: Stage 2: Questionnaire testing
time frame: 12 months
description: Validity and reliability testing of new questionnaire
measure: Frequency and severity of symptoms
time frame: 15 months
description: Frequency and severity of symptoms
measure: Relationship between surgical technique and symptoms
time frame: 15 months
description: Relationship between surgical technique and symptoms
measure: Effect of hormonal therapy usage and symptoms
time frame: 15 months
description: Effect of hormonal therapy usage and symptoms
measure: Length of time since surgery and development of symptoms
time frame: 15 months
description: Length of time since surgery and development of symptoms
arm group label: Stage 1 Focus Groups
description: The focus groups will involve transgender women who have completed gender confirmation surgery who volunteer to discuss their postoperative experience regarding bladder function, genital complaints, and sexual function.
arm group label: Stage 2 Questionnaire Groups
description: Stage 2 participants will be asked to complete a questionnaire packet after surgery followed by a second questionnaire completion 2 weeks later. Participants' operative notes and postoperative visit records will be reviewed.
intervention type: Other
intervention name: Focus group interviews
description: Focus group participants will be asked about their postoperative urogynecologic experience. Confidentiality will be enforced and participants will be made aware that they may opt out of answering any questions.
arm group label: Stage 1 Focus Groups
intervention type: Diagnostic Test
intervention name: Questionnaire packet
description: Participants will be asked to complete a questionnaire packet comprised of three previously validated questionnaires and one newly created focused questionnaire. They will be asked to complete the new questionnaire again 2 weeks later. We estimate about 10 minutes will be required to complete the packet.
arm group label: Stage 2 Questionnaire Groups
study pop: 
sampling method: Non-Probability Sample
criteria: 
gender: Male
gender based: Yes
gender description: Study participants involve transgender individuals who were born phenotypically male but identify as female.
minimum age: 18 Years
maximum age: N/A
healthy volunteers: Accepts Healthy Volunteers
last name: Sarah Huber, MD
role: Principal Investigator
affiliation: Weill Medical College of Cornell University
last name: Sarah Huber, MD
phone: 212-746-5352
email: sah2757@med.cornell.edu
facility: 
status: Recruiting
contact: 
country: United States
citation: Selvaggi G, Bellringer J. Gender reassignment surgery: an overview. Nat Rev Urol. 2011 May;8(5):274-82. doi: 10.1038/nrurol.2011.46. Epub 2011 Apr 12.
PMID: 21487386
citation: Clements-Nolle K, Marx R, Katz M. Attempted suicide among transgender persons: The influence of gender-based discrimination and victimization. J Homosex. 2006;51(3):53-69. doi: 10.1300/J082v51n03_04.
PMID: 17135115
citation: Kailas M, Lu HMS, Rothman EF, Safer JD. PREVALENCE AND TYPES OF GENDER-AFFIRMING SURGERY AMONG A SAMPLE OF TRANSGENDER ENDOCRINOLOGY PATIENTS PRIOR TO STATE EXPANSION OF INSURANCE COVERAGE. Endocr Pract. 2017 Jul;23(7):780-786. doi: 10.4158/EP161727.OR. Epub 2017 Apr 27.
PMID: 28448757
citation: Revol M, Servant JM, Banzet P. [Surgical treatment of male-to-female transsexuals: a ten-year experience assessment]. Ann Chir Plast Esthet. 2006 Dec;51(6):499-511. doi: 10.1016/j.anplas.2006.02.006. Epub 2006 Apr 19. French.
PMID: 16626849
citation: Hess J, Rossi Neto R, Panic L, Rubben H, Senf W. Satisfaction with male-to-female gender reassignment surgery. Dtsch Arztebl Int. 2014 Nov 21;111(47):795-801. doi: 10.3238/arztebl.2014.0795.
PMID: 25487762
citation: Goddard JC, Vickery RM, Qureshi A, Summerton DJ, Khoosal D, Terry TR. Feminizing genitoplasty in adult transsexuals: early and long-term surgical results. BJU Int. 2007 Sep;100(3):607-13. doi: 10.1111/j.1464-410X.2007.07017.x.
PMID: 17669144
citation: Buncamper ME, van der Sluis WB, van der Pas RSD, Ozer M, Smit JM, Witte BI, Bouman MB, Mullender MG. Surgical Outcome after Penile Inversion Vaginoplasty: A Retrospective Study of 475 Transgender Women. Plast Reconstr Surg. 2016 Nov;138(5):999-1007. doi: 10.1097/PRS.0000000000002684.
PMID: 27782992
citation: Jarolim L, Sedy J, Schmidt M, Nanka O, Foltan R, Kawaciuk I. Gender reassignment surgery in male-to-female transsexualism: A retrospective 3-month follow-up study with anatomical remarks. J Sex Med. 2009 Jun;6(6):1635-1644. doi: 10.1111/j.1743-6109.2009.01245.x. Epub 2009 Mar 30.
PMID: 19473463
citation: Rossi Neto R, Hintz F, Krege S, Rubben H, Vom Dorp F. Gender reassignment surgery--a 13 year review of surgical outcomes. Int Braz J Urol. 2012 Jan-Feb;38(1):97-107. doi: 10.1590/s1677-55382012000100014.
PMID: 22397771
citation: Hoebeke P, Selvaggi G, Ceulemans P, De Cuypere G, T'Sjoen G, Weyers S, Decaestecker K, Monstrey S. Impact of sex reassignment surgery on lower urinary tract function. Eur Urol. 2005 Mar;47(3):398-402. doi: 10.1016/j.eururo.2004.10.008. Epub 2004 Dec 2.
PMID: 15716207
citation: Lawrence AA. Patient-reported complications and functional outcomes of male-to-female sex reassignment surgery. Arch Sex Behav. 2006 Dec;35(6):717-27. doi: 10.1007/s10508-006-9104-9. Epub 2006 Nov 16.
PMID: 17109225
citation: Horbach SE, Bouman MB, Smit JM, Ozer M, Buncamper ME, Mullender MG. Outcome of Vaginoplasty in Male-to-Female Transgenders: A Systematic Review of Surgical Techniques. J Sex Med. 2015 Jun;12(6):1499-512. doi: 10.1111/jsm.12868. Epub 2015 Mar 26.
PMID: 25817066
citation: Kuhn A, Santi A, Birkhauser M. Vaginal prolapse, pelvic floor function, and related symptoms 16 years after sex reassignment surgery in transsexuals. Fertil Steril. 2011 Jun;95(7):2379-82. doi: 10.1016/j.fertnstert.2011.03.029. Epub 2011 Apr 2.
PMID: 21458798
citation: Kuhn A, Hiltebrand R, Birkhauser M. Do transsexuals have micturition disorders? Eur J Obstet Gynecol Reprod Biol. 2007 Apr;131(2):226-30. doi: 10.1016/j.ejogrb.2006.03.019. Epub 2006 May 5.
PMID: 16678333
citation: Dietrich W, Haitel A, Huber JC, Reiter WJ. Expression of estrogen receptors in human corpus cavernosum and male urethra. J Histochem Cytochem. 2004 Mar;52(3):355-60. doi: 10.1177/002215540405200306.
PMID: 14966202
responsible party type: Sponsor
mesh term: Gender Dysphoria
sharing ipd: Undecided