Our Summary

This research paper discusses a method for creating a vagina for transgender women - those transitioning from male to female. The usual method for this surgery involves using skin from the penis. However, this method doesn’t always provide enough tissue to create a vagina with a satisfactory depth. Additionally, patients need to follow a complex aftercare routine to avoid the new vagina shrinking.

In response, the researchers looked at using tissue from the sigmoid colon - an area of the large intestine - instead. They reviewed the medical records of all transgender women who underwent this surgery at the University of Miami between 2014 and 2017.

The results showed that the average depth of the new vaginas was about 14 centimeters. In 67% of patients, there were no complications, and all patients were able to engage in sexual activity. There were no cases of damage to the bowel, leaking from the area where the tissue was stitched together, death of the sigmoid tissue, slipping of the new vagina, inflammation, pain during sex, or excessive secretions.

The researchers concluded that using sigmoid colon tissue is a reliable method for creating a vagina with a satisfactory depth that can be used for sexual activity. They now recommend this method for transgender women whose penis length is less than 11.4 centimeters.

FAQs

  1. What is the primary technique used for creating the neovagina in transwomen?
  2. What are some of the limitations of using the penile inversion technique for vaginoplasty?
  3. What are the benefits of using the sigmoid colon for vaginoplasty, and for whom is this technique recommended?

Doctor’s Tip

A helpful tip a doctor might tell a patient about vaginoplasty using the sigmoid colon technique is to ensure they follow postoperative care instructions carefully, including regular dilation routines to maintain the depth and functionality of the neovagina. It is also important to attend follow-up appointments to monitor for any potential complications and ensure optimal healing.

Suitable For

Patients who are typically recommended for sigmoid vaginoplasty include transwomen with insufficient penile tissue for vaginoplasty using traditional techniques, as well as those who wish to avoid the cumbersome postoperative dilation routines associated with penile inversion techniques. In particular, patients with phallus length less than 11.4 centimeters may benefit from this procedure. It is important to note that this technique has been shown to be safe and effective in achieving satisfactory vaginal depth and function in these patients.

Timeline

Before vaginoplasty:

  • Patient undergoes consultation with a gender reassignment service
  • Patient may undergo hormone therapy and/or psychological evaluation
  • Patient discusses surgical options with their healthcare provider
  • Patient may undergo preoperative preparations such as hair removal in the genital area

After vaginoplasty:

  • Patient undergoes surgery to create a neovagina using the sigmoid colon
  • Patient stays in the hospital for recovery
  • Patient may experience some discomfort and swelling in the surgical area
  • Patient is instructed on how to care for the surgical site and prevent complications
  • Patient may need to perform postoperative dilation routines to maintain neovaginal depth
  • Patient attends follow-up appointments to monitor healing and address any concerns

Overall, sigmoid vaginoplasty is shown to be a reliable technique for achieving a satisfactory vaginal depth that is sexually functional with low complication rates. It is now offered as a standard of care for transwomen with insufficient tissue for penile inversion techniques.

What to Ask Your Doctor

Some questions a patient may consider asking their doctor about vaginoplasty, specifically sigmoid vaginoplasty, include:

  1. What are the potential risks and complications associated with sigmoid vaginoplasty?
  2. How long is the recovery process after sigmoid vaginoplasty and what can I expect during this time?
  3. Will I need to undergo any additional procedures or treatments after the surgery?
  4. How long will the neovagina created through sigmoid vaginoplasty last and will I need any future revisions or maintenance?
  5. What are the potential benefits of choosing sigmoid vaginoplasty over other techniques for vaginoplasty?
  6. How will sigmoid vaginoplasty impact my sexual function and sensations?
  7. Are there any specific guidelines or recommendations I should follow before and after the surgery to ensure optimal outcomes?
  8. Will I need to undergo any additional procedures, such as dilation, to maintain the neovagina after sigmoid vaginoplasty?
  9. How experienced are you in performing sigmoid vaginoplasty and what is your success rate with this procedure?
  10. Are there any alternative options or techniques I should consider for vaginoplasty, and how do they compare to sigmoid vaginoplasty in terms of outcomes and risks?

Reference

Authors: Salgado CJ, Nugent A, Kuhn J, Janette M, Bahna H. Journal: Biomed Res Int. 2018 May 10;2018:4907208. doi: 10.1155/2018/4907208. eCollection 2018. PMID: 29862275