Sex Reassignment Surgery (vaginoplasty)

Vaginoplasty is a form of surgery used to help transition of transwomen, with the aim of providing them with a female-like sexual organ to enable sexual intercourse. There are numerous techniques used to achieve this. The doctor in charge of treatment is responsible for discussing which procedure to use depending on individual’s needs, the amount of existing genital tissue, and their history of genital surgeries.

Which vaginoplasty techniques are available?
The most popular forms of vaginoplasty currently used are as follows:
  • Penile skin inversion with scrotal skin graft extension  is one such standard procedure.
  • Colonic vaginoplasty involves using a small part of the colon. This procedure is suited to individual whose existing tissue isn’t adequate, but a deeper vaginal cavity is desirable. Alternatively, this surgery can be used to correct an initial surgery that caused neovaginal stenosis.
  • Peritoneal vaginoplasty is a procedure previously only used to treat women born without a vaginal cavity, although this technique is now used in sex reassignment surgery.
  • Thigh or groin skin graft vaginoplasty is generally used in cases where only slight expansion of the vaginal cavity is necessary, where the existing genital tissue is insufficient, or in patients looking to avoid grafting from the abdomen.
Similar to other forms of surgery, vaginoplasty carries with it the risk of various complications and side effects, with many of the following examples resulting from a lack of post-surgery care or use of the neovagina before it is recommended to do so:
  • There is a chance that incisions will split open or not heal properly.
  • Neovaginal prolapse
  • Neovaginal stenosis
  • Shallow vaginal depth
  • Urinary tract stenosis
  • Neovaginal perforation into the abdomen or colon
  • Dehiscence of clitoral tissue
  • Inform the doctor in charge if they are taking any regular medication.
  • For those on hormonal therapy medication, these should be halted for the 2 weeks leading up to the surgery, or 4 weeks in cases where this medication is in injection form.
  • Refrain from drinking and eating for at least 8 hours leading up to the surgery.
  • Halt any drugs or herbal medicine that increase bleeding risk for the 2 weeks leading up to surgery.
  • Avoid smoking and drinking alcohol for 4–6 weeks leading up to surgery.
  • Those who have tested positive for HIV should ensure their CD4 levels are stable prior to surgery.
  • A special device used to expand the vaginal cavity should be inserted under the supervision of a doctor once the post-surgery protective gauze has been removed as this will prevent stenosis and ensure sufficient depth.
  • A sanitary pad should be used as there may still be some bleeding for the week following surgery.
  • Hormonal therapy should be re-initiated around 1 month after surgery. Dosage adjustment is necessary thus consultation with an endocrinologist/specialist is advised.
  • Sexual intercourse is possible once the wound has healed, which usually takes approximately 6-8 weeks.
  • Patients should rest for around 3–5 weeks. Healing process is likely to fully complete after approximately 6 months.
Sex reassignment is categorized as one of major and complex surgical procedures, meaning that high levels of training and experience are required to perform successfully. Pride Clinic has a team of professionals specializing in a comprehensive range of associated fields, working alongside one another to share knowledge and expertise to ensure the diverse needs of their patients are effectively met.

To find out more information, please contact:

Pride Clinic 
Tel: 063-221-0957 or 02-066-8888 ext. 1378

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