Why Pelvic Floor Therapy Matters for Trans Women After Vaginoplasty

For trans women, gender-affirming surgery is a major step toward aligning the body with gender identity. Vaginoplasty in particular is important in helping people feel more at home in their bodies. But it is important to remember that this process is not limited to surgery alone. Pelvic floor physiotherapy plays a critical role in keeping the pelvic floor muscles working well after vaginoplasty.

Why Are the Pelvic Floor Muscles Important?
The pelvic floor muscles play an important role in bladder and bowel control and in sexual function. Because these muscles and the surrounding structures are cut during vaginoplasty, they need support during recovery after surgery. Research shows that pelvic floor physiotherapy before and after surgery helps prevent problems such as pain and urinary incontinence during recovery and helps protect the new vaginal canal.

What Does This Study Show?
In one study, 77 trans women undergoing vaginoplasty were offered pelvic floor physiotherapy before and after surgery. Of these women, 94% attended at least one session. First, examinations before surgery showed pelvic floor dysfunction (difficulty with muscle control or weakness) in 42% of participants. After surgery, this rate dropped considerably. In addition, those who attended physiotherapy before surgery were found to be less likely to have pelvic floor dysfunction after surgery.

Dilation and Physiotherapy Support
After surgery, dilation is very important for the healing and maintenance of the neovagina. According to the study, patients who took part in pelvic floor physiotherapy were more successful with dilation. In particular, positioning advice, muscle relaxation exercises and breathing techniques from physiotherapists made the process more comfortable.
Why Physiotherapy Matters for People With a History of Trauma
The study found that people with a history of trauma have a higher risk of pelvic floor dysfunction. With this kind of support, people who have had difficult experiences in the past can get to know and control their pelvic muscles better. Physiotherapy before surgery makes the process less stressful and speeds up recovery.

In Conclusion
Pelvic floor physiotherapy after vaginoplasty provides major support for trans women during their recovery after surgery. This support makes it possible for the pelvic floor muscles to work well, for dilation to become easier and for overall quality of life to improve. If you are going through this process, consider getting support from a pelvic floor physiotherapist and working with specialists to make the process easier.
Tuğçe Atalay, Specialist Physiotherapist
Jiang DD, Gallagher S, Burchill L, Berli J, Dugi D 3rd. Implementation of a Pelvic Floor Physical Therapy Program for Transgender Women Undergoing Gender-Affirming Vaginoplasty. Obstet Gynecol. 2019 May;133(5):1003-1011.