Our Summary

This research paper presents a step-by-step guide to a new surgical procedure called total laparoscopic sigmoid vaginoplasty. This technique is aimed at transgender women who have underdeveloped penises or those who have had unsuccessful initial vaginoplasty surgeries. It’s also for biological women who, due to birth defects or other issues, don’t have a functional vagina.

In this procedure, a surgeon creates a new vaginal cavity and removes the testicles, and then shapes the penis and scrotum into a clitoris and vulva. Simultaneously, another surgeon detaches a portion of the sigmoid, a part of the large intestine, and guides it through the newly formed vaginal tunnel. This segment is then stitched to the perineum and the inverted skin from the penis. The length of the segment is measured using a special tool, and then it’s stapled at the appropriate level. The new vagina is then attached to the promontory, a part of the spinal column. The continuity of the bowel is restored within the abdomen.

The researchers report that this technique has low complication rates. They have performed 63 surgeries mainly on transgender women since 2008 with a minimum of one year of follow-up. There were a few complications, like rectal perforations and leakages, but these were managed without leading to long-term issues or needing to switch to open surgery.

In conclusion, the researchers affirm that this new surgical procedure is safe and effective when performed by an experienced team and can provide good surgical and functional results. It can be used for initial vaginoplasty surgeries as well as for revisions.

FAQs

  1. Who is the total laparoscopic sigmoid vaginoplasty procedure suitable for?
  2. What are the steps involved in the total laparoscopic sigmoid vaginoplasty procedure?
  3. What have been the results and complications of this new surgical procedure according to the research?

Doctor’s Tip

A helpful tip that a doctor might tell a patient about vaginoplasty is to carefully follow all pre-operative and post-operative instructions provided by the surgical team. This can help minimize the risk of complications and ensure a successful outcome. Additionally, patients should communicate openly with their healthcare providers about any concerns or questions they may have throughout the process.

Suitable For

Overall, patients who are typically recommended for vaginoplasty include transgender women who desire gender-affirming surgery, biological women with congenital abnormalities or other conditions that affect the functionality of their vagina, and individuals who have had unsuccessful previous vaginoplasty surgeries. It is important for patients to undergo a thorough evaluation by a qualified healthcare provider to determine if they are suitable candidates for vaginoplasty and to discuss the potential risks and benefits of the procedure.

Timeline

Before Vaginoplasty:

  • Patient undergoes consultation with a surgeon to discuss the procedure and expectations
  • Patient undergoes pre-operative testing and evaluation
  • Patient may need to undergo hormone therapy to prepare the body for surgery
  • Patient receives instructions on how to prepare for surgery, including fasting and medication adjustments
  • Surgery is scheduled and patient is admitted to the hospital for the procedure

After Vaginoplasty:

  • Patient is monitored closely in the hospital for complications and to ensure proper healing
  • Patient may experience pain, swelling, and discomfort in the surgical area
  • Patient is given instructions on how to care for the surgical site and manage pain
  • Patient may need to follow a strict post-operative care plan, including dilation exercises to maintain the new vaginal cavity
  • Follow-up appointments are scheduled to monitor healing and address any concerns or complications
  • Patient may need to undergo physical therapy and counseling to adjust to the changes in their body
  • Patient can expect improved sexual function and satisfaction, as well as improved mental health and quality of life.

What to Ask Your Doctor

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

  1. What specific type of vaginoplasty procedure are you recommending for me?
  2. What are the potential risks and complications associated with this surgery?
  3. What is the expected recovery time and post-operative care for this procedure?
  4. How many times have you performed this specific type of vaginoplasty surgery?
  5. What are the expected outcomes in terms of appearance, function, and sensation?
  6. Will I need to undergo any additional procedures or treatments before or after the surgery?
  7. How will this surgery affect my sexual function and satisfaction?
  8. What are the long-term implications and potential challenges of this surgery?
  9. What are the alternatives to vaginoplasty that I should consider?
  10. Can you provide me with before and after photos of patients who have undergone this procedure?

Reference

Authors: Bouman MB, Buncamper ME, van der Sluis WB, Meijerink WJ. Journal: Fertil Steril. 2016 Dec;106(7):e22-e23. doi: 10.1016/j.fertnstert.2016.08.049. Epub 2016 Sep 22. PMID: 27666563