Our Summary

This research paper discusses a common surgical procedure used in “gender-affirming bottom surgery” called penile inversion vaginoplasty (PIV). In this procedure, penile tissue is repurposed to create a new vagina, helping individuals to physically match their gender identity. The paper provides detailed steps and advice from the senior author on how to achieve the best functional and aesthetic results from this surgery, to ensure the overall happiness and satisfaction of transgender patients.

FAQs

  1. What is penile inversion vaginoplasty (PIV)?
  2. How does penile inversion vaginoplasty help individuals to match their physical body with their gender identity?
  3. What are some tips for achieving the best results from a penile inversion vaginoplasty?

Doctor’s Tip

One helpful tip a doctor might tell a patient about vaginoplasty is to carefully follow post-operative care instructions, including proper wound care, hygiene practices, and avoiding strenuous activities to promote healing and reduce the risk of complications. It is also important for patients to attend follow-up appointments to monitor their progress and address any concerns or issues that may arise. Additionally, patients should communicate openly with their healthcare provider about their goals, expectations, and any questions or fears they may have before and after the surgery. Open communication can help ensure that the patient’s needs are addressed and that they have a positive experience with the procedure.

Suitable For

Patients who are typically recommended for vaginoplasty are transgender individuals who have undergone hormone therapy and have lived as their identified gender for a significant amount of time. These individuals may experience gender dysphoria related to their genitalia and seek surgery to align their physical body with their gender identity. It is important for patients to meet certain criteria, such as being in good overall health, having realistic expectations for the surgery, and undergoing psychological evaluation to ensure they are mentally prepared for the procedure.

Additionally, patients must have sufficient penile tissue available for the creation of a neovagina through penile inversion vaginoplasty. This procedure is most commonly recommended for transgender women, or individuals assigned male at birth who identify as female. It is important for patients to have a thorough understanding of the risks and benefits of vaginoplasty, as well as the potential complications and recovery process.

Overall, vaginoplasty is recommended for transgender individuals who are seeking to align their physical body with their gender identity and improve their overall quality of life. It is important for patients to work closely with their healthcare providers to determine if vaginoplasty is the right choice for them and to ensure they receive proper care and support throughout the surgical process.

Timeline

Before vaginoplasty:

  1. Patient consults with a gender-affirming surgeon to discuss their desire for vaginoplasty and to determine if they are a suitable candidate for the procedure.
  2. Patient undergoes psychological evaluation to assess their mental readiness for surgery and to ensure they have realistic expectations.
  3. Patient undergoes hormone therapy and hair removal in the genital area to prepare for surgery.
  4. Patient receives pre-operative instructions and guidelines on how to prepare for the surgery, including abstaining from certain medications and food prior to the procedure.

After vaginoplasty:

  1. Patient undergoes the penile inversion vaginoplasty procedure, which involves reshaping penile tissue into a new vagina.
  2. Patient stays in the hospital for a few days post-surgery to monitor for any complications and to manage pain.
  3. Patient begins a strict post-operative care routine, including dilation exercises to maintain the depth and width of the new vagina.
  4. Patient attends follow-up appointments with the surgeon to monitor healing progress and address any concerns or complications.
  5. Patient undergoes physical therapy and counseling to help adjust to their new genital anatomy and to address any emotional or psychological issues related to the surgery.

Overall, the timeline for a patient undergoing vaginoplasty can vary depending on individual factors such as healing time, complications, and adherence to post-operative care instructions. With proper preparation and follow-up care, vaginoplasty can greatly improve the quality of life and mental well-being of transgender individuals seeking gender-affirming surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with vaginoplasty surgery?
  2. What is the expected recovery time and post-operative care after vaginoplasty?
  3. How will the surgery impact sexual function and sensation in the vaginal area?
  4. Will I need to undergo any additional procedures or treatments in the future to maintain the results of the surgery?
  5. What are the realistic expectations for the aesthetic appearance of the new vagina?
  6. How experienced is the surgical team in performing vaginoplasty procedures, and what is their success rate?
  7. Are there any specific requirements or criteria that I need to meet before undergoing vaginoplasty surgery?
  8. What type of anesthesia will be used during the procedure, and what are the potential side effects?
  9. How long will the results of the surgery last, and are there any long-term considerations to keep in mind?
  10. Are there any alternative treatment options or procedures that I should consider before deciding on vaginoplasty?

Reference

Authors: Bustos SS, Rios-Sanchez M, Fahradyan V. Journal: Cureus. 2024 Sep 8;16(9):e68949. doi: 10.7759/cureus.68949. eCollection 2024 Sep. PMID: 39385869