Our Summary

This research paper is about a study of a surgical procedure called gender-affirming vaginoplasty. This is a surgery carried out on individuals who were assigned male at birth but identify as female, to create a vagina and vulva. This operation can be complex, with potential risks to various parts of the body including the anal and urethral sphincters, urethra and rectum.

The researchers looked back at patients who had this surgery between May 2016 and July 2019, performed by the same surgeon. They also explained their technique for the procedure.

In total, 200 operations were carried out during the study period. The age of the patients ranged from 15 to 70, with an average age of 41. The patients’ body mass index (a measure of body fat based on height and weight) ranged from 16 to 50.5, with an average of 27. The depth of the created vagina ranged from 10 to 16 cm, with an average depth of 13.7 cm.

The research found that patients with a higher body mass index tended to have a slightly deeper vagina. There were complications in a small number of cases, including injuries to the rectum and urethra, and issues with the vaginal and introital (entrance to the vagina) opening. Some patients also experienced temporary stress urinary incontinence (leakage when coughing, sneezing, etc.), which resolved later.

Overall, the study suggests that this type of surgery is technically challenging but can be performed with a low rate of complications when using an anatomically based approach.

FAQs

  1. What is the purpose of gender-affirming vaginoplasty?
  2. What are the possible complications of a gender-affirming vaginoplasty procedure?
  3. Does body mass index affect the outcome of a gender-affirming vaginoplasty?

Doctor’s Tip

A helpful tip a doctor might tell a patient about vaginoplasty is to carefully follow post-operative care instructions to reduce the risk of complications and promote proper healing. This may include keeping the surgical area clean and dry, avoiding strenuous activities, and attending follow-up appointments with your surgeon. It is also important to communicate any concerns or changes in symptoms to your healthcare provider promptly.

Suitable For

Patients who are typically recommended for vaginoplasty are individuals assigned male sex at birth who have gender dysphoria and desire to undergo gender-affirming surgery to create a vulva and vaginal canal. These patients may have already undergone hormone therapy and psychological evaluation as part of their gender transition process. It is important that patients have realistic expectations about the outcomes of surgery and are in good overall health before undergoing vaginoplasty.

Timeline

Before vaginoplasty, a patient typically undergoes a series of consultations with a plastic surgeon or urologist specializing in gender-affirming surgeries. They may also undergo hormone therapy and psychological evaluations to ensure they are mentally and physically prepared for the procedure. The patient will also need to stop smoking and avoid certain medications that can increase the risk of complications during surgery.

After vaginoplasty, the patient will spend several days in the hospital recovering from the procedure. They will need to follow a strict post-operative care plan, which may include taking pain medications, using vaginal dilators to maintain the depth and width of the vaginal canal, and avoiding strenuous activities. The patient will also need to attend follow-up appointments with their surgeon to monitor their healing progress and address any complications that may arise.

Overall, the recovery process for vaginoplasty can be lengthy and require patience and dedication from the patient. However, with proper care and support, many individuals are able to achieve their desired outcomes and experience improved quality of life after undergoing gender-affirming vaginoplasty.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with vaginoplasty surgery?
  2. How long is the recovery period and what can I expect during the recovery process?
  3. What are the expected outcomes in terms of vaginal depth and appearance?
  4. Will I need to follow any specific post-operative care instructions?
  5. How soon after surgery can I resume sexual activity?
  6. Are there any long-term effects or considerations I should be aware of?
  7. Will I need to undergo any additional procedures or treatments in the future?
  8. What are the qualifications and experience of the surgeon performing the procedure?
  9. Are there any alternative treatment options that I should consider?
  10. How can I best prepare for vaginoplasty surgery, both physically and emotionally?

Reference

Authors: Shoureshi P, Dy GW, Dugi D 3rd. Journal: J Urol. 2021 Apr;205(4):1110-1118. doi: 10.1097/JU.0000000000001516. Epub 2020 Nov 20. PMID: 33216669