Our Summary

This research paper looks at a surgical procedure called rectosigmoid vaginoplasty, which is used to create or reconstruct a vagina. The study followed 84 patients who had this surgery between 1992 and 2014. These included people with gender identity disorder, individuals born without a vagina, people with a condition known as female pseudohermaphroditism, and those who had gynecologic cancers requiring radical pelvic surgery. The paper states that all the patients were able to leave the hospital within two weeks of the surgery without any loss of the surgical flap. The complications that occurred were relatively minor and included things like difficulty going to the bathroom, excessive mucus secretion, and some issues with the new vagina. In terms of size, the average length and width of the new vagina three and a half years after surgery were about 13.2 cm and 3.8 cm, respectively. When asked about their satisfaction with the procedure, 70% of patients said they were extremely satisfied, 11% said they were happy, 12% said they were fairly satisfied, and 7% said they were not satisfied. The conclusion of the study is that rectosigmoid vaginoplasty is a safe and effective method for creating a new vagina that functions well and looks natural.

FAQs

  1. What is rectosigmoid vaginoplasty and who can benefit from this procedure?
  2. What complications can occur after a rectosigmoid vaginoplasty?
  3. How satisfied were patients with the results of their rectosigmoid vaginoplasty, and what was the average size of the new vagina?

Doctor’s Tip

One tip a doctor might give a patient considering vaginoplasty is to thoroughly discuss the procedure, potential risks, and expected outcomes with their healthcare provider. It is important for patients to have a clear understanding of what to expect before, during, and after the surgery in order to make an informed decision. It is also important for patients to follow their doctor’s post-operative care instructions carefully to ensure proper healing and optimal results.

Suitable For

Patients who are typically recommended for vaginoplasty include:

  1. Individuals with gender dysphoria who are seeking gender-affirming surgery to align their physical appearance with their gender identity.
  2. Individuals who were born with a congenital condition that resulted in the absence or underdevelopment of a vagina, such as Mayer-Rokitansky-Küster-Hauser syndrome.
  3. Individuals with female pseudohermaphroditism, a condition in which a person has external female genitalia but internal male reproductive organs.
  4. Individuals who have undergone radical pelvic surgery for gynecologic cancers and require reconstruction of the vagina.
  5. Individuals who have experienced trauma or injury to the vaginal area and require surgical reconstruction.

Timeline

Before vaginoplasty:

  • Patient consults with a surgeon specializing in gender affirmation surgeries to discuss the procedure, risks, benefits, and expected outcomes.
  • Patient undergoes a thorough medical evaluation to ensure they are a suitable candidate for surgery.
  • Patient may need to undergo hormone therapy and/or hair removal in the genital area to prepare for surgery.
  • Patient may need to undergo psychological evaluation and counseling to ensure they are mentally prepared for the surgery and its potential impact on their mental health.
  • Patient may need to obtain letters of support from mental health professionals and/or primary care providers before surgery can be scheduled.

After vaginoplasty:

  • Patient is closely monitored in the hospital for a few days post-surgery to ensure proper healing and manage any post-operative pain.
  • Patient may need to use vaginal dilators to maintain the depth and width of the new vagina and prevent scar tissue from forming.
  • Patient is advised to abstain from sexual activity for a period of time to allow the vagina to heal properly.
  • Patient attends follow-up appointments with their surgeon to monitor healing progress and address any concerns or complications that may arise.
  • Patient may undergo additional surgeries for revisions or adjustments to the new vagina if necessary.
  • Patient may undergo physical therapy to help with pelvic floor muscle strength and function.
  • Patient may experience improvements in their mental health, self-esteem, and quality of life as they adjust to their new anatomy and identity.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with vaginoplasty surgery?

  2. What is the recovery process like after vaginoplasty surgery?

  3. How long will it take to see the final results of the surgery?

  4. Will I need to undergo additional surgeries or procedures in the future?

  5. How will vaginoplasty surgery affect my sexual function and sensation?

  6. What kind of aftercare or follow-up appointments will be necessary after the surgery?

  7. Are there any specific lifestyle changes or restrictions I should be aware of post-surgery?

  8. How long do the results of vaginoplasty surgery typically last?

  9. Can you provide me with before and after photos of patients who have undergone vaginoplasty surgery?

  10. What are the qualifications and experience of the surgical team performing the vaginoplasty procedure?

Reference

Authors: Kim SK, Park JW, Lim KR, Lee KC. Journal: Arch Plast Surg. 2017 Jan;44(1):48-52. doi: 10.5999/aps.2017.44.1.48. Epub 2017 Jan 20. PMID: 28194347