Vaginoplasty description
PROCEDURE DESCRIPTION :
The technique used is the one step penile inversion. It is done under general or spinal anaesthesia as an inpatient in the hospital. The duration is 2 ½ hours. The scrotal skin is removed along with the testicles. The neoclitoris is fashioned from the tip of the penis (glans) keeping its blood and nerve supply (neurovascular island flap).
The labia majora are formed with some of the penis skin, the hood and the labia minora with urethral mucosa and penis skin.
The space for the vagina is dissected behind the meatus (urinary tube) between the bladder and the rectum. The penis skin is inverted to line the vagina and the thinned scrotal skin graft is sutured to the end of the penis skin tube. Hair roots on the scrotal skin graft are destroyed with the cauthery. A urinary catheter is put into the bladder, a packing of cotton covered with a condom is put inside the vagina. The prostate is not removed.
Skin grafts are occasionally necessary. One location for these can be the inner posterior thigh. A split thickness graft is taken and leaves a discolorated area of skin when healed. This issue will be discussed with your surgeon preoperatively.
INTENDED RESULTS :
A natural appearing female genital (vulva and vagina) with adequate depth for vaginal intercourse and normal sensation.
RECUPERATION AND HEALING :
Patients will need to be in Montreal for a 14 day period. Two or three days are spent at the residence preoperatively, two days at the hospital and five to six days postoperatively at the residence. You should plan to stay off work for 4 to 6 weeks.
The evening of the following day of your surgery, you will be moved out of bed and encouraged to sit in a chair for a while or take a few steps. The morning after, walking is strongly encouraged.
RISKS :
The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. All surgical procedures have some degrees of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are unusual. Please refer to the « Risks for Vaginoplasty» for more detailed information.
OTHER PROCEDURE :
Breast augmentation, Adam’s apple shaving or other cosmetic procedures of reasonable duration can be done at the same time.
Secondary cosmetic improvements to the vulva are generally not required. Occasionally, patients may chose to have a revision to enhance the genital details.
