Genital surgery is associated with high rates of pelvic floor and sexual dysfunction.
A 2025 systematic review and meta-analysis1 examined 25 studies on pelvic floor outcomes after genital “gender-affirming” surgery. The findings show a high prevalence of complications among both male and female patients:
| Type of Dysfunction | Males (vaginoplasty) | Females (hysterectomy & phalloplasty) |
|---|---|---|
| Pelvic organ prolapse | 1–7.5% | 3.8% |
| Urinary incontinence | up to 15% | up to 50% |
| Urinary irritative symptoms | up to 20% | up to 37% |
| Sexual dysfunction | 25–75% | 54% |