Fisioterapia e cirurgia de redesignação sexual em mulheres transgêneras: uma revisão sistemática
Arquivos
Data
2021-02-23
Autores
Santos, Natália Siste 
Orientadores
Amaral, Maria Teresa Pace do
Tipo
Trabalho de conclusão de curso
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: O termo transgênero aborda um amplo espectro de não identidade com o sexo biológico. Inclui-se aqui o homem e a mulher transexual que realiza a transição social para o gênero que se identifica, podendo assumir um novo nome. Essa transição versa de tratamento hormonal à cirurgia de redesignação sexual. Complicações relacionadas ao assoalho pélvico e à saúde sexual podem ser consequentes ao procedimento cirúrgico. Nesse contexto, a fisioterapia pode contribuir para a prevenção e/ou tratamento destas complicações. Objetivo: Verificar e discutir as evidências científicas e contribuições da fisioterapia para a cirurgia de redesignação sexual em mulheres transgêneras. Metodologia: Revisão sistemática realizada nas bases de dados BVS, Cochrane, PEDro, Pubmed, SciELO. Resultados: Inicialmente, foram encontrados 477 artigos, e destes, 474 foram excluídos por não abordarem a fisioterapia e cirurgia de redesignação sexual. Três artigos foram lidos integralmente e um excluído por ser carta ao editor, restando dois estudos para análise qualitativa. Síntese da análise: Ambos os artigos encontraram alta incidência de disfunção do assoalho pélvico previamente à cirurgia (42% e 77,5%). As voluntárias submetidas à fisioterapia alcançaram resolução total ou parcial dos sintomas preexistentes até o momento da cirurgia e apresentaram menor incidência de disfunções após a cirurgia em comparação àquelas que não se submeteram ao tratamento. Houve baixa incidência de complicações após a cirurgia, com destaque para a estenose da neovagina. Esta complicação foi tratada com dilatadores vaginais, sendo que a maioria das voluntárias atingiu a dilatação desejada. Conclusão: A fisioterapia pélvica, apesar da escassa literatura voltada às mulheres trans, tem papel fundamental no tratamento das disfunções do assoalho pélvico e sexual. As estratégias terapêuticas já existentes para a população cisgênera podem auxiliar também, as mulheres trans. Entretanto há necessidade e urgência em entender as demandas específicas destas mulheres a fim de melhorar o acolhimento no sistema de saúde, extinguindo as discriminações que ainda ocorrem por profissionais da saúde.
Background: The term transgender addresses a broad spectrum of non-identity with biological sex. This includes the transsexual woman and man who makes the social transition to the gender that she/he identifies, being able to take on a new name. This transition goes from hormonal treatment to sex reassignment surgery. Complications related to the pelvic floor and sexual health can be a consequence of the surgical procedure. In this context, physical therapy can contribute to the prevention and / or treatment of these complications. Objective: To verify and discuss the scientific evidence and contributions of physiotherapy to sex reassignment surgery in transgender women. Methodology: Systematic review carried out in the BVS, Cochrane, PEDro, Pubmed, SciELO databases. Results: Initially, 477 articles were found and of these, 474 were excluded for not addressing physiotherapy and sex reassignment surgery. Three articles were read in full and one was excluded because it was a letter to the editor, leaving two studies for qualitative analysis. Summary of the analysis: Both articles found a high incidence of pelvic floor dysfunction prior to surgery (42% and 77.5%). The volunteers who underwent physical therapy achieved total or partial resolution of the pre-existing symptoms until the time of surgery and had a lower incidence of dysfunctions after surgery compared to those who did not undergo treatment. There was a low incidence of complications after surgery, with emphasis on neovagine stenosis. This complication was treated with vaginal dilators and most of the volunteers reached the desired dilation. Conclusion: Pelvic floor physiotherapy, despite the scarce literature aimed at trans women has a fundamental role in the treatment of pelvic floor and sexual disorders. The therapeutic strategies that already exist for the cisgender population can also help trans women. However, there is a need and urgency to understand the specific demands of these women in order to improve the reception in the health system, extinguishing the discrimination that still occurs by health professionals.
Background: The term transgender addresses a broad spectrum of non-identity with biological sex. This includes the transsexual woman and man who makes the social transition to the gender that she/he identifies, being able to take on a new name. This transition goes from hormonal treatment to sex reassignment surgery. Complications related to the pelvic floor and sexual health can be a consequence of the surgical procedure. In this context, physical therapy can contribute to the prevention and / or treatment of these complications. Objective: To verify and discuss the scientific evidence and contributions of physiotherapy to sex reassignment surgery in transgender women. Methodology: Systematic review carried out in the BVS, Cochrane, PEDro, Pubmed, SciELO databases. Results: Initially, 477 articles were found and of these, 474 were excluded for not addressing physiotherapy and sex reassignment surgery. Three articles were read in full and one was excluded because it was a letter to the editor, leaving two studies for qualitative analysis. Summary of the analysis: Both articles found a high incidence of pelvic floor dysfunction prior to surgery (42% and 77.5%). The volunteers who underwent physical therapy achieved total or partial resolution of the pre-existing symptoms until the time of surgery and had a lower incidence of dysfunctions after surgery compared to those who did not undergo treatment. There was a low incidence of complications after surgery, with emphasis on neovagine stenosis. This complication was treated with vaginal dilators and most of the volunteers reached the desired dilation. Conclusion: Pelvic floor physiotherapy, despite the scarce literature aimed at trans women has a fundamental role in the treatment of pelvic floor and sexual disorders. The therapeutic strategies that already exist for the cisgender population can also help trans women. However, there is a need and urgency to understand the specific demands of these women in order to improve the reception in the health system, extinguishing the discrimination that still occurs by health professionals.
Descrição
Citação
SANTOS, Natália Siste. Fisioterapia e cirurgia de redesignação sexual em mulheres transgêneras: uma revisão sistemática. 2021. 43f. Trabalho de conclusão de curso (Graduação em Fisioterapia) - Instituto de Saúde e Sociedade, Universidade Federal de São Paulo, Santos, 2021.