Our Summary

This research paper is about a study that was conducted to understand how often vaginal stenosis (VS) - a narrowing or tightening of the vagina - happens after a surgical procedure known as vaginoplasty, and if the chances change depending on the type of surgical technique used or how long it’s been since the surgery. The researchers looked at past studies on the topic and found 59 that fit their criteria. They studied a total of 7338 patients from these studies.

They found that, on average, VS happens in about 5.83% of cases. This goes up to 9.68% when combining VS with other complications related to the narrowing of the vaginal opening. When looking at different surgical techniques, they found that the rate of VS was 5.7% for a technique called penile inversion vaginoplasty, and 0.2% for a technique called primary intestinal vaginoplasty.

Interestingly, the researchers found that the rate of complications related to the narrowing of the vaginal opening was quite similar between these two techniques. They believe this could be due to the fact that both techniques require the use of sutures and the need for post-surgery dilation.

The researchers concluded that the overall rate of VS appears to be lower than what was previously thought. They believe this could be because their study included more recent research and only looked at primary (or first-time) vaginoplasty. They also pointed out that there is a need for a more standardized way to define and diagnose VS.

FAQs

  1. What is the overall incidence of vaginal stenosis (VS) after vaginoplasty according to the study?
  2. How does the rate of VS differ between penile inversion vaginoplasty and primary intestinal vaginoplasty?
  3. Why does the research suggest a need for a standardized definition of vaginal stenosis?

Doctor’s Tip

A helpful tip a doctor might tell a patient about vaginoplasty is to follow post-operative care instructions carefully, including proper dilation techniques to prevent vaginal stenosis. Regular dilation can help maintain the size and shape of the vagina after surgery. It is important to communicate any concerns or discomfort with your healthcare provider to address them promptly.

Suitable For

Patients who are typically recommended for vaginoplasty include transgender women seeking gender-affirming surgery, individuals with congenital conditions such as Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, and individuals seeking vaginal reconstruction after trauma or cancer treatment. The decision to undergo vaginoplasty is made in consultation with a medical provider and typically involves a thorough evaluation of the patient’s physical and mental health, as well as their specific goals and expectations for surgery.

Timeline

Before vaginoplasty:

  1. Consultation with a healthcare provider to discuss the procedure, risks, benefits, and expectations.
  2. Pre-operative evaluations and tests to ensure the patient is a suitable candidate for surgery.
  3. Psychological evaluation and counseling to assess readiness for surgery.
  4. Pre-operative instructions to prepare for surgery, such as stopping certain medications or fasting.
  5. Surgical consent process where the patient agrees to the procedure and understanding of potential risks.

After vaginoplasty:

  1. Recovery in the hospital or surgical facility immediately after surgery.
  2. Post-operative care instructions, including wound care, pain management, and activity restrictions.
  3. Follow-up appointments with the surgeon to monitor healing and address any concerns.
  4. Gradual resumption of normal activities as advised by the healthcare provider.
  5. Start of dilation therapy to maintain vaginal depth and width.
  6. Long-term follow-up care to monitor for complications, such as vaginal stenosis, and address any issues that may arise.

What to Ask Your Doctor

  1. What is the specific surgical technique you will be using for my vaginoplasty?
  2. What is the expected recovery time and post-operative care for preventing vaginal stenosis?
  3. What are the potential risks and complications associated with vaginoplasty, including the risk of vaginal stenosis?
  4. How often will I need to follow up with you after the surgery to monitor for any signs of vaginal stenosis?
  5. What can I do to minimize the risk of developing vaginal stenosis after vaginoplasty?
  6. If vaginal stenosis does occur, what are the treatment options available to address it?
  7. How will vaginal stenosis impact sexual function and overall quality of life post-vaginoplasty?
  8. Can you provide me with any resources or support groups for individuals who have experienced vaginal stenosis after vaginoplasty?

Reference

Authors: De Rosa P, Kent M, Regan M, Purohit RS. Journal: Urology. 2024 Apr;186:69-74. doi: 10.1016/j.urology.2024.02.005. Epub 2024 Feb 15. PMID: 38364980