Our Summary

This research paper is about how different types of tissue used in gender-affirming vaginoplasty (a surgery to create a vagina for transgender women) can produce natural lubrication. This is important for the sexual satisfaction and health of people who have had this surgery.

The researchers looked at scientific studies to see how tissues from the penis and scrotum, the urethra (the tube where urine comes out), the colon (part of the large intestine), and the peritoneum (the lining of the abdomen) work when used to line the new vagina.

They found 580 studies, but only 28 of them met their criteria. Unfortunately, none of the studies measured how much lubrication the new vagina produced. From what they know about the anatomy of these tissues, the penis and scrotum cannot produce lubrication on their own, but if the urethra or certain glands are kept during the surgery, some lubrication might be possible. The colon and peritoneum can produce fluids, but it’s not controlled by sexual arousal and the amount may not be right, which could be a problem for some people.

The researchers concluded that none of the tissues they looked at can produce lubrication like a natural vagina. They also said it can be hard to tell if the fluids produced by the new vagina are normal or a sign of a problem. Finally, they said that there isn’t enough evidence to recommend one type of surgery over another based on how well it can produce lubrication.

FAQs

  1. Can the tissues used in vaginoplasty produce natural lubrication?
  2. What types of tissues were reviewed in this research to see their ability to produce lubrication in a new vagina?
  3. What are the implications of the findings regarding the production of lubrication by the new vagina?

Doctor’s Tip

A doctor might tell a patient considering vaginoplasty that while different types of tissue used in the surgery can potentially produce some lubrication, it may not be as natural or sufficient as a cisgender woman’s vagina. It’s important for patients to have realistic expectations about this aspect of the surgery and to discuss any concerns with their healthcare provider. Additionally, regular follow-up appointments and open communication with their healthcare team are crucial for monitoring for any potential issues related to lubrication and overall vaginal health.

Suitable For

Patients who are considering gender-affirming vaginoplasty are typically recommended this surgery if they are transgender women looking to align their physical body with their gender identity. Vaginoplasty is a major surgery that creates a vagina using tissue from the patient’s own body. It is important for patients to have realistic expectations about the outcomes of the surgery, including the potential for natural lubrication.

It is important for patients to discuss their goals and expectations with their healthcare provider before undergoing vaginoplasty. While the research on tissue used in vaginoplasty and natural lubrication is still limited, patients should be aware that none of the tissues studied can produce lubrication like a natural vagina. Patients should also be prepared for potential challenges related to lubrication and sexual satisfaction after surgery.

Overall, patients who are considering vaginoplasty should have a thorough discussion with their healthcare provider about the potential outcomes of the surgery, including the potential for natural lubrication. It is important for patients to be well-informed and have realistic expectations about the results of the surgery.

Timeline

Before vaginoplasty, a patient typically undergoes counseling and a series of evaluations to determine if they are a suitable candidate for the surgery. This process may include hormone therapy, living as their identified gender for a certain period of time, and obtaining letters of recommendation from mental health professionals.

During the surgery, tissue is typically taken from the penis and scrotum, the urethra, the colon, or the peritoneum to create the vaginal canal. The surgery can take several hours and requires a hospital stay for recovery.

After vaginoplasty, patients will need to follow a strict post-operative care regimen, which may include dilation exercises to prevent the new vagina from closing up, taking pain medication, and attending follow-up appointments with their surgeon.

In terms of lubrication, the research suggests that none of the tissues used in vaginoplasty can produce natural lubrication like a biological vagina. This means that patients may need to use artificial lubricants to prevent discomfort during sexual activity. It is also important for patients to communicate with their healthcare provider about any changes in vaginal discharge or discomfort to ensure proper healing.

What to Ask Your Doctor

Some questions a patient should ask their doctor about vaginoplasty in relation to this research paper could include:

  1. Can you explain the different types of tissue used in vaginoplasty and how they may affect lubrication in the new vagina?
  2. What are the potential risks and benefits of using tissues from the penis and scrotum, the urethra, the colon, and the peritoneum in vaginoplasty?
  3. How likely is it that the new vagina will be able to produce natural lubrication after surgery?
  4. Are there any specific techniques or surgeries that can help improve lubrication in the new vagina?
  5. What are the potential signs or symptoms of inadequate lubrication in the new vagina, and how should they be addressed?
  6. How will you monitor and assess the function of the new vagina in terms of lubrication post-surgery?
  7. Are there any alternative options or treatments available to help with lubrication in the new vagina if needed?
  8. What are the long-term implications of the type of tissue used in vaginoplasty on sexual satisfaction and health?

Reference

Authors: O’Dwyer C, Kumar S, Wassersug R, Khorrami A, Mukherjee S, Mankowski P, Genoway K, Kavanagh AG. Journal: Sex Med Rev. 2023 Jun 27;11(3):212-223. doi: 10.1093/sxmrev/qead015. PMID: 37105933