Our Summary

This research paper is about secondary surgeries that some patients have after a specific type of gender confirmation surgery called penile inversion vaginoplasty. About a third of patients have these secondary operations to improve how the surgical area functions and looks. The most common of these surgeries are to adjust the opening of the vagina, the clitoris, the labia, and the urethra. The paper uses a case study of a 32-year-old transgender woman who had a surgery to fix a functional issue with the opening of her vagina and to enhance the appearance of her clitoris and labia. The paper goes into detail about what happens during the surgery and what care should be taken after the surgery. This information is also presented in accompanying videos.

FAQs

  1. What is penile inversion vaginoplasty and why do some patients require secondary surgical revisions?
  2. What are the most commonly performed revisions after penile inversion vaginoplasty?
  3. What are the intraoperative steps and postoperative considerations for revision surgery after penile inversion vaginoplasty?

Doctor’s Tip

One helpful tip a doctor might tell a patient about vaginoplasty is to follow postoperative care instructions closely to optimize healing and reduce the risk of complications. This may include proper wound care, 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 may be recommended for vaginoplasty include transgender women who are seeking gender affirmation surgery, individuals with congenital abnormalities affecting the genitalia, and those who have undergone previous genital surgery and are seeking revision or improvement of functional or aesthetic outcomes.

Timeline

Before vaginoplasty:

  1. Consultation with a surgeon to discuss the procedure, potential risks, and expected outcomes.
  2. Pre-operative assessments and tests to ensure the patient is a suitable candidate for surgery.
  3. Psychological evaluation and counseling to assess readiness for gender confirmation surgery.
  4. Preparation for surgery, including fasting and possibly stopping certain medications.

After vaginoplasty:

  1. Recovery period in the hospital, typically lasting a few days.
  2. Follow-up appointments with the surgeon to monitor healing and address any concerns.
  3. Gradual resumption of normal activities, with restrictions on strenuous exercise and sexual activity.
  4. Dilating the vaginal canal regularly to maintain depth and prevent narrowing.
  5. Possible complications such as infection, bleeding, or delayed wound healing, which may require additional treatment.
  6. Long-term follow-up to monitor the success of the surgery and address any issues that may arise.

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 for vaginoplasty?
  3. Will I need to undergo any additional surgeries or revisions after the initial vaginoplasty procedure?
  4. What are the options for addressing functional concerns such as introital webbing or urethral complications after vaginoplasty?
  5. Can you provide information on the surgical techniques you use for vaginoplasty and potential revisions?
  6. How experienced are you in performing vaginoplasty and revision surgeries?
  7. What are the expected outcomes in terms of both function and aesthetics after vaginoplasty and potential revisions?
  8. Are there any alternative treatments or procedures that could address my concerns without surgery?
  9. What is the cost of vaginoplasty surgery and potential revisions, and will my insurance cover any of these procedures?
  10. Are there any specific lifestyle changes or precautions I should take before or after vaginoplasty surgery?

Reference

Authors: Morris MP, Wang CW, Lane M, Morrison SD, Kuzon WM. Journal: Plast Reconstr Surg. 2022 Jun 1;149(6):1198e-1201e. doi: 10.1097/PRS.0000000000009159. Epub 2022 Apr 15. PMID: 35426869