130. The Impact of Physical Therapy on Recovery Outcomes Following Vaginoplasty For Gender Affirmation

PURPOSE: Postoperative physical therapy (PT) has been shown to accelerate recovery and optimize functional outcomes in various types of surgery. However, little is known about the role of PT in recovery after full depth vaginoplasty for gender affirmation. This study aimed to assess the frequency of PT use and its perceived benefits for patients undergoing vaginoplasty, particularly regarding dilation success, relaxation methods, functional adaptation, and the management of post-surgical issues. METHODS: A retrospective analysis was performed at the University of Colorado, including patients who had undergone full depth vaginoplasty for gender affirmation. Patients were eligible if they were 18 years or older and had at least six months of postoperative follow-up. Data were drawn from both medical records and patient surveys, with a paired samples T-test used for statistical evaluation. RESULTS: From 2020 to 2023, 51 eligible patients were identified, of whom 33 completed the survey and 23 received postoperative pelvic floor PT. Demographic data revealed that 41 (80%) participants underwent primary full-depth vaginoplasty and 10 (20%) underwent revision full-depth vaginoplasty. The racial composition was predominantly White/Caucasian (84.3%), with smaller representations from Asian (2%), African American (2%), Native American (2%), and other races (5.9%). The ethnicity breakdown showed that 3.9% were Hispanic, while 96.1% were non-Hispanic. All participants were male by sex and identified as female by gender identity. Patients who engaged in more PT sessions expressed greater satisfaction with their surgery and showed better dilation and bowel function outcomes. Those who felt well-supported by their physical therapists reported higher satisfaction with their post-surgical education process. Furthermore, patients who maintained an active lifestyle were more likely to attend additional PT sessions, and greater attendance was associated with improved dilation outcomes and the development of better coping strategies. CONCLUSION: This study suggests that PT plays a valuable role in aiding dilation, supporting relaxation and functional adaptation, and preventing complications following vaginoplasty. These benefits promote both physical and psychological recovery. Further studies should expand this research to multiple institutions and develop standardized tools tailored to the unique needs of this patient population.