Our Summary

This research paper discusses the reasons why a woman might need a vaginoplasty, a procedure that reshapes or reconstructs the vagina. These reasons can include birth defects, damage from cancer treatment, or as a part of gender transition surgery. However, this procedure comes with a considerable risk of both immediate and longer-term complications. The paper reviews how to evaluate and manage the new vagina and addresses how to deal with complications such as infections, narrowing, abnormal connections, sagging, and inflammation. It emphasizes that doctors who look after patients who have had a vaginoplasty need to understand the importance of long-term follow-up care, including how to evaluate and manage any complications.

FAQs

  1. What are the various indications for undergoing a vaginoplasty?
  2. What are some of the potential immediate and long-term complications of vaginoplasty?
  3. Why is long-term follow-up and care important for patients who have undergone a vaginoplasty?

Doctor’s Tip

A helpful tip a doctor might tell a patient about vaginoplasty is to ensure they attend regular follow-up appointments for long-term care and monitoring of any potential complications. It is important for patients to communicate any concerns or symptoms they may experience after the surgery to their healthcare provider promptly. Additionally, practicing good hygiene and following post-operative care instructions can help prevent complications and promote healing.

Suitable For

Patients who are typically recommended for vaginoplasty include those with congenital conditions such as adrenal hyperplasia, cloacal malformations, and Müllerian agenesis, as well as acquired conditions such as stenosis from radiation or surgical resection for malignancy. Additionally, individuals seeking gender affirmation may also undergo vaginoplasty. It is important for gynecologists to understand the potential risks and complications associated with vaginoplasty and provide long-term follow-up care for these patients.

Timeline

Before vaginoplasty:

  • Patient consults with a healthcare provider to discuss the reasons for seeking vaginoplasty
  • Patient undergoes a physical examination and may need to undergo psychological evaluation
  • Patient discusses surgical options, risks, and benefits with the healthcare provider
  • Patient may need to undergo hormone therapy or other preparations before the surgery

After vaginoplasty:

  • Patient undergoes surgery to create a neovagina
  • Patient may experience pain, swelling, and discomfort in the days and weeks following surgery
  • Patient follows post-operative care instructions, including wound care and pain management
  • Patient attends follow-up appointments with the healthcare provider to monitor healing and address any complications
  • Patient may need to undergo dilation therapy to maintain the depth and width of the neovagina
  • Patient may experience complications such as stenosis, fistula, prolapse, or neovaginal colitis, which may require further treatment
  • Patient may need to undergo additional surgeries or interventions to address complications or improve the outcome of the vaginoplasty

What to Ask Your Doctor

Some questions a patient should ask their doctor about vaginoplasty include:

  1. What are the potential risks and complications associated with vaginoplasty?
  2. How long is the recovery period and what can I expect during the recovery process?
  3. Will I need to undergo any additional procedures or treatments before or after the vaginoplasty?
  4. What are the expected outcomes and results of the vaginoplasty procedure?
  5. How will the neovagina be maintained and what follow-up care will be required?
  6. What is the likelihood of experiencing complications such as stenosis, fistula, prolapse, or neovaginal colitis?
  7. How often should I schedule follow-up appointments after the surgery?
  8. Are there any specific lifestyle changes or restrictions I should be aware of after the vaginoplasty?
  9. What should I do if I experience any unusual symptoms or complications following the surgery?
  10. Can you provide me with information on support groups or resources for individuals who have undergone vaginoplasty?

Reference

Authors: Amies Oelschlager AM, Kirby A, Breech L. Journal: Curr Opin Obstet Gynecol. 2017 Oct;29(5):316-321. doi: 10.1097/GCO.0000000000000391. PMID: 28696998