126. Patient Reported Outcomes and Complications Following Penile Inversion Vaginoplasty (PIV): A One-year Prospective Study

PURPOSE: As the number of patients presenting for genital gender affirming surgery increases, there is heightened interest in understanding the impact of these procedures on psychosocial functioning. Previous studies examining penile inversion vaginoplasty (PIV) employ ad-hoc survey instruments, have relatively short follow up times, and/or do not report complications. In this one-year prospective study, we aim to examine measures of anxiety, depression, body image, and psychosocial functioning following PIV and determine the impact of complications on these measures. METHODS: Patients undergoing PIV at a single institution were eligible for the study. Participants were administered surveys one month preoperatively and one year postoperatively. The survey included validated instruments measuring depression (PHQ-9), anxiety (GAD-7), psychosocial functioning (BODY-Q Social Functioning Module) and body image (BODY-Q Body Image Module). Complication data were collected one year postoperatively from the medical record. Preoperative and postoperative responses as well as complications were analyzed using descriptive statistics and Wilcoxon rank-sum testing. RESULTS: From 2019-2023, a total of 90 participants were approached and 50 (55%) successfully completed both the preoperative and one-year postoperative surveys. The mean age was 44.9 (SD 15.5). The majority (N=41, 80%) had a complication during the study period and 4 patients (8%) had a complication requiring readmission or reoperation. Overall, patients had a significant decrease in median depression (PHQ-9 preop=5 [3-8], postop=4 [0-6], p=0.02) and anxiety (GAD7 preop=6 [3-9], postop=3 [0-6], p=0.004) scores as well as improvements in body image (BODY-Q Body Image preop=38 [22-50] postop=65 [54-85], p<0.001) and psychosocial functioning (BODY-Q Social Functioning preop=55 [40-60] postop=57 [48-71], p=0.03) postoperatively. There were no significant differences in psychosocial outcomes between patients who had a complication and those who did not on bivariate analysis. CONCLUSION: In this single-center prospective study, we found patients had significant improvements in measures of anxiety, depression, body image, and psychosocial functioning. While the rate of overall complications is high, there was no difference in anxiety, depression, body image, or psychosocial functioning at one year. Although extended follow up is needed, these findings suggest acute postoperative complications do not impact long term outcomes.