Our Summary

Vaginoplasty is a common surgery for people who feel their biological sex does not match their gender identity, which involves constructing a vulva and vaginal canal. One type of this surgery, called penile inversion vaginoplasty, uses the existing genital tissues to create these new structures. Other types of vaginoplasty use various surgical methods to achieve similar results. The surgery typically improves the patient’s quality of life greatly, but there can be complications in up to 70% of cases. However, most complications do not have long-term effects and can be managed without additional surgery. Yet, serious complications like injuries to the rectum or urethra can significantly impact the patient’s experience. There have been advances in surgical techniques that show promise in reducing complications and improving results, but more long-term studies are needed.

FAQs

  1. What is vaginoplasty and who is it typically for?
  2. What are the different types of vaginoplasty and how do they differ?
  3. What are some of the potential complications of this surgery and how are they managed?

Doctor’s Tip

One helpful tip a doctor might give a patient before undergoing vaginoplasty is to carefully follow all pre-operative instructions provided by the surgical team. This may include stopping certain medications, avoiding smoking, and maintaining a healthy lifestyle to reduce the risk of complications during and after surgery. Additionally, it is important for patients to have realistic expectations about the results of the surgery and to have open communication with their healthcare team about any concerns or questions they may have. Regular follow-up appointments with the surgeon and other healthcare providers are also crucial for monitoring healing and addressing any issues that may arise.

Suitable For

Patients who are typically recommended for vaginoplasty include:

  1. Transgender women: Individuals assigned male at birth who identify as female may undergo vaginoplasty to align their physical appearance with their gender identity.

  2. Non-binary individuals: People who do not strictly identify as male or female may also choose to undergo vaginoplasty to achieve a more gender-affirming body.

  3. Individuals with gender dysphoria: People who experience distress or discomfort due to a misalignment between their gender identity and assigned sex at birth may benefit from vaginoplasty as part of their gender transition.

  4. Individuals with intersex conditions: Some individuals born with differences in sex development may undergo vaginoplasty to address genital anomalies or improve sexual function.

  5. People seeking genital reconstruction: Individuals who have experienced trauma, injury, or congenital abnormalities affecting their genitalia may opt for vaginoplasty to restore function and improve quality of life.

It is important for individuals considering vaginoplasty to undergo a thorough evaluation by a qualified healthcare provider to assess their physical and mental health, readiness for surgery, and potential risks and benefits. Collaborative care involving mental health professionals, surgeons, and other specialists is often recommended to ensure the best outcomes for patients undergoing vaginoplasty.

Timeline

Before Vaginoplasty:

  1. Initial consultation with a gender-affirming surgeon to discuss goals, expectations, and potential risks.
  2. Psychological evaluation and counseling to ensure readiness for surgery.
  3. Hormone therapy to achieve desired physical changes and prepare the body for surgery.
  4. Pre-operative tests and screenings to ensure the patient is healthy enough for surgery.

After Vaginoplasty:

  1. Hospital stay for monitoring and recovery immediately following surgery.
  2. Post-operative care, including pain management, wound care, and monitoring for complications.
  3. Dilating the new vaginal canal regularly to prevent narrowing or scarring.
  4. Follow-up appointments with the surgeon to monitor healing and address any concerns.
  5. Physical therapy to help with pelvic floor muscle rehabilitation and improve sensation.
  6. Psychological support to navigate changes in body image and sexual function.
  7. Gradual resumption of normal activities, including sexual intercourse, as advised by the surgeon.

Overall, the timeline for a patient before and after vaginoplasty can vary depending on individual circumstances and the specific surgical technique used. It is important for patients to have realistic expectations, follow post-operative instructions carefully, and seek support from healthcare providers and mental health professionals throughout the process.

What to Ask Your Doctor

  1. What type of vaginoplasty procedure do you recommend for me and why?
  2. What are the potential risks and complications associated with vaginoplasty?
  3. What is the recovery process like and how long can I expect to be out of work or other activities?
  4. How will vaginoplasty affect my sexual function and sensation?
  5. Will I need to undergo additional surgeries or procedures in the future?
  6. What are the chances of needing revision surgery and what factors contribute to that?
  7. Are there any specific post-operative care instructions I should follow to optimize my results?
  8. How experienced are you in performing vaginoplasty and what is your success rate with this procedure?
  9. Can you provide me with before and after photos of previous patients who have undergone vaginoplasty?
  10. Are there any alternative treatments or procedures I should consider before deciding on vaginoplasty?

Reference

Authors: Morrison SD, Claes K, Morris MP, Monstrey S, Hoebeke P, Buncamper M. Journal: Nat Rev Urol. 2023 May;20(5):308-322. doi: 10.1038/s41585-022-00705-y. Epub 2023 Feb 1. PMID: 36726039