Our Summary

This research paper is about a specific type of surgery called intestinal vaginoplasty, which is increasingly being performed on transgender women (male-to-female transsexuals). The surgery is attractive because it leaves no visible scars, there’s a low chance of the newly created vagina shrinking, it maintains depth, naturally produces mucus, and has a low rate of complications.

In Japan, this surgery is becoming more popular, but there isn’t much data on its use there. This study looked at 18 trans women who had the surgery at Okayama University Hospital Gender Center between 2012 and 2017. They used a specific part of the intestine, called the rectosigmoid colon, to create the vagina.

They found that one patient experienced a leak at the surgery site, but this was well-managed with non-surgical treatment. Two patients had their vaginas slip out of place, which required more surgery. These complications are similar to those found in other studies.

To prevent the vagina from slipping, the length of the intestine used needs to be carefully decided so it doesn’t become loose but also isn’t too tight. The researchers concluded that this surgery is a reliable technique for the Japanese population.

FAQs

  1. What is an intestinal vaginoplasty and why might it be preferred over other types of surgery for transgender women?
  2. What complications were found during this study of intestinal vaginoplasties performed at Okayama University Hospital Gender Center?
  3. How can the risk of the newly created vagina slipping out of place be minimized?

Doctor’s Tip

A doctor might tell a patient considering vaginoplasty to carefully consider the type of surgery being performed and to discuss potential complications and risks with their surgeon. It is important to choose a surgeon with experience in the specific type of surgery being considered and to follow all post-operative care instructions to minimize the risk of complications.

Suitable For

Overall, patients who are typically recommended for vaginoplasty, specifically intestinal vaginoplasty, are transgender women who desire to have a vagina created through surgery. These patients may have gender dysphoria and feel that having a vagina aligns with their gender identity. It is important for these patients to have realistic expectations about the surgery and understand the potential risks and complications involved. Additionally, patients should be in good overall health and have a stable mental health status before undergoing vaginoplasty.

Timeline

Before vaginoplasty:

  1. Patient consults with a gender dysphoria specialist or surgeon to discuss surgical options for gender confirmation.
  2. Patient undergoes psychological evaluation to assess readiness for surgery.
  3. Patient may need to undergo hormone therapy for a certain period of time before surgery.
  4. Patient discusses surgical procedure, potential risks, and expected outcomes with their surgeon.
  5. Patient undergoes pre-operative tests and evaluations to ensure they are a good candidate for surgery.

After vaginoplasty:

  1. Patient is closely monitored in the hospital for any signs of complications immediately following surgery.
  2. Patient may experience pain, swelling, and discomfort in the surgical site.
  3. Patient is given post-operative care instructions, including wound care and pain management.
  4. Patient may need to stay in the hospital for a few days to recover before being discharged.
  5. Patient follows up with their surgeon for post-operative appointments to monitor healing and address any concerns.
  6. Patient may need to undergo dilation therapy to maintain the depth and width of the newly created vagina.
  7. Patient may experience improved self-esteem, body image, and overall satisfaction with their gender identity.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with intestinal vaginoplasty?

  2. How long is the recovery process and what can I expect in terms of pain and discomfort?

  3. Will I need to follow a specific post-operative care routine?

  4. How long will it take before I can resume normal activities, including sexual intercourse?

  5. What are the chances of the newly created vagina shrinking over time?

  6. Are there any long-term effects or risks associated with intestinal vaginoplasty?

  7. How will my sexual function be affected after the surgery?

  8. Will I need to undergo additional surgeries or procedures in the future?

  9. Are there any specific considerations or differences in the outcome of intestinal vaginoplasty for transgender women compared to cisgender women?

  10. What is the success rate of intestinal vaginoplasty, particularly in terms of maintaining depth and natural mucus production in the vagina?

Reference

Authors: Mukai Y, Sakurai T, Watanabe T, Sako T, Sugimoto M, Kimata Y, Mori Y, Nagasaka T, Namba Y. Journal: Acta Med Okayama. 2019 Jun;73(3):205-211. doi: 10.18926/AMO/56862. PMID: 31235967