Our Summary

This research paper looks at a procedure called vaginoplasty, which is a surgical process often used to construct a vagina for male to female transgender individuals. The approach often used involves using tissue from the penis and scrotum, but it can have lots of complications. The researchers look at data from 47 patients who had this surgery in Italy, using a new technique involving a “Y” shaped piece from the urethra.

They also looked at previous research to understand the complications that can happen after the surgery. All of the patients in this study were asked to follow a certain routine to help the new vagina stretch and grow properly. Two patients were lost from the study, but after a year, most of the patients (around 89%) were able to reach orgasm, around 76% were having sexual intercourse, and the average depth of the new vagina was 11 cm.

The depth stayed pretty much the same over the year, and only one patient was unhappy with how it looked. This new method seems to give good results that look and function well, without serious complications. The researchers suggest that there needs to be a standard way to care for patients after this surgery, especially around the stretching routine. They also say that further studies with more patients are needed to make sure that this is the best method.

FAQs

  1. What is the most commonly used technique for vaginoplasty in Male to Female transgenders?
  2. What are the common short and long-term complications of vaginoplasty?
  3. What is the importance of a standardized postoperative follow up protocol, particularly with regards to the postoperative dilatation regimen in vaginoplasty?

Doctor’s Tip

A helpful tip a doctor might tell a patient about vaginoplasty is to follow a standardized neo-vaginal dilation protocol post-surgery. This can help maintain the depth and function of the neo-vagina, as well as improve sexual satisfaction and overall outcomes. It is important to adhere to the recommended dilatation regimen to achieve optimal results. Additionally, it is important to have regular follow-up appointments with your healthcare provider to monitor your progress and address any concerns or complications that may arise.

Suitable For

Patients who are typically recommended for vaginoplasty include male to female transgender individuals seeking sex affirmation surgery. These patients may experience gender dysphoria related to their genitalia and desire to have a neo-vagina created. Vaginoplasty is a major surgical procedure that involves creating a vagina using penile and scrotal tissue, and requires a thorough evaluation by a qualified healthcare provider to determine if the patient is a suitable candidate for surgery. Additionally, patients should be mentally and physically prepared for the procedure, as well as willing to adhere to postoperative care instructions, including dilation therapy to maintain vaginal depth and function.

Timeline

Before vaginoplasty:

  • Patient undergoes psychological evaluation and counseling to determine readiness for surgery
  • Patient may undergo hormone therapy to feminize their body and prepare for surgery
  • Patient meets with surgeon to discuss surgical options and risks
  • Patient undergoes pre-operative testing and evaluation to ensure they are a suitable candidate for surgery

During vaginoplasty:

  • Surgeon performs surgery to create a neo-vagina using inverted penile and scrotal flaps
  • Surgery typically takes several hours and may require an overnight hospital stay
  • Patient is monitored for complications and given pain medication as needed
  • Patient begins post-operative care, including dilation therapy to maintain neo-vaginal depth and prevent complications

After vaginoplasty:

  • Patient continues dilation therapy as prescribed by surgeon to maintain neo-vaginal depth
  • Patient attends follow-up appointments with surgeon to monitor healing and address any concerns
  • Patient may experience some discomfort and swelling in the weeks following surgery
  • Patient gradually resumes normal activities and may begin to engage in sexual intercourse as healing progresses
  • Patient experiences improved self-esteem and quality of life as they adjust to their new anatomy and gender identity.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with vaginoplasty?
  2. What is the success rate of achieving sexual function and sensation after vaginoplasty?
  3. How long is the recovery period after vaginoplasty and what can I expect during the healing process?
  4. What type of dilation regimen will I need to follow postoperatively and for how long?
  5. Will I need to undergo any additional surgeries or treatments in the future?
  6. How often will I need to follow up with you after the surgery?
  7. What can I do to optimize my outcomes and reduce the risk of complications?
  8. What are the potential long-term effects of vaginoplasty on my overall health and well-being?
  9. Are there any specific lifestyle changes or precautions I need to take after undergoing vaginoplasty?
  10. Can you provide me with before and after photos of previous patients who have undergone vaginoplasty using your technique?

Reference

Authors: Ongaro L, Garaffa G, Migliozzi F, Rizzo M, Traunero F, Falcone M, Bucci S, Cai T, Palmieri A, Trombetta C, Liguori G. Journal: Int J Impot Res. 2020 Nov;33(7):726-732. doi: 10.1038/s41443-021-00470-3. Epub 2021 Sep 24. PMID: 34561673