Our Summary

This research paper discusses a surgical technique used to help transgender women (those transitioning from male to female) who may not have enough skin for traditional genital surgery due to procedures like radical circumcision or puberty blockers. The technique is called peritoneal pull-through vaginoplasty, and it has typically been used in cisgender women (those who identify with their sex assigned at birth) who lack a vagina due to birth defects or trauma.

In this study, they used this technique on 52 transgender women aged 19 to 52 years. They took two flaps of tissue from the peritoneum (the lining of the abdomen) and used them to create a vagina. The rest of the female genitalia (clitoris, labia, and urethra) were also reconstructed. After the surgery, the new vagina was packed for a week and then dilated for a year.

The results were generally positive. The majority of the patients were happy with the results, including sensitivity, lubrication, and the ability to have sexual intercourse. There were some complications, such as prolonged swelling and minor tissue damage, but none required additional surgeries. One patient needed their clitoris size reduced due to hypersensitivity and another requested laser treatment for scar reduction.

The researchers concluded that this technique offers promising results for transgender women, providing a self-lubricating vagina with minimal scarring and complications, and a high degree of patient satisfaction.

FAQs

  1. What is peritoneal pull-through vaginoplasty and who is it typically used for?
  2. What were the general results and complications of using this technique on transgender women in this study?
  3. How does the peritoneal pull-through vaginoplasty technique benefit transgender women according to this research?

Doctor’s Tip

A helpful tip a doctor might tell a patient about vaginoplasty is to carefully follow post-operative instructions provided by the surgeon. This may include proper wound care, avoiding strenuous activities, and regularly using dilators as instructed to maintain the size and depth of the new vagina. It is important to attend all follow-up appointments to monitor healing and address any concerns or complications that may arise. Additionally, patients should communicate openly with their healthcare provider about any discomfort, changes, or questions they may have during the recovery process.

Suitable For

Overall, vaginoplasty is typically recommended for transgender women who are looking to align their physical appearance with their gender identity. It is important for patients to undergo thorough psychological evaluation and counseling before undergoing the surgery to ensure they fully understand the risks and benefits, as well as have realistic expectations. Additionally, patients should be in good overall health and have appropriate social support systems in place for the post-operative recovery period. Each patient’s individual circumstances and goals will ultimately determine if vaginoplasty is the right choice for them.

Timeline

Before the vaginoplasty, the patient would have undergone consultations with their healthcare provider, psychological evaluations, hormone therapy, and possibly hair removal in the genital area. They would also have received information on the surgical procedure, potential risks and complications, and post-operative care.

After the vaginoplasty, the patient would experience some pain, swelling, and discomfort in the genital area. They would need to follow a strict post-operative care routine, including keeping the area clean, taking prescribed medications, and avoiding strenuous activities. The new vagina would need to be packed for a week and then dilated regularly for a year to maintain its shape and depth.

Over time, the patient would gradually see improvements in sensitivity, lubrication, and the ability to engage in sexual intercourse. They may experience some complications, such as swelling or tissue damage, which may require additional treatment. Overall, the patient would likely experience increased satisfaction with their body and gender identity following the vaginoplasty procedure.

What to Ask Your Doctor

Some questions a patient should ask their doctor about vaginoplasty include:

  1. What are the potential risks and complications of peritoneal pull-through vaginoplasty?
  2. How long is the recovery process after surgery, and what can I expect during this time?
  3. Will I need to take hormones or undergo other treatments before or after the surgery?
  4. How soon after surgery can I resume sexual activity?
  5. What kind of follow-up care will be necessary, and how often will I need to see my doctor?
  6. How will the new vagina function in terms of sensitivity, lubrication, and sexual intercourse?
  7. Are there any specific lifestyle changes or precautions I will need to take post-surgery?
  8. Will I need to undergo any additional procedures or treatments in the future?
  9. How long do the results of the surgery typically last?
  10. What are the qualifications and experience of the surgical team performing the procedure?

Reference

Authors: Castanon CDG, Matic S, Bizic M, Stojanovic B, Bencic M, Grubor N, Pusica S, Korac G, Djordjevic ML. Journal: Urology. 2022 Aug;166:301-302. doi: 10.1016/j.urology.2022.05.001. Epub 2022 May 10. PMID: 35550383