Vaginoplasty

What is vaginoplasty?

Vaginoplasty is a form of invasive surgery that returns the vagina to its youthful appearance. In some cases, the procedure is used to reconstruct a vagina, or to create one from penile tissue in case of an SRS surgery. For some patients, the embarrassment caused by the appearance of their vagina interferes with their sex life. For others, the loss of friction during intercourse is the issue. But many patients seek vaginoplasty surgery because of chronic discomfort.

How does vaginoplasty work?

1. The surgeon begins by making an incision, or a series of incisions, in the walls of the vagina. The muscles on either side of the pelvis are tightened with dissolving stitches. Excess vaginal lining and tissue is removed during the process. If there are no complications, the patient can go home the same day. 2. In essence, the stitching together of muscles and tissue decreases the size of the vaginal cavity. This increases friction, and some say sensitivity, during sex. There's also a significant cosmetic improvement, which is often likened to a youthful, pre-pregnancy vagina.

As well as the obvious cosmetic benefits, vaginoplasty surgery can support the womb, bladder and bowel more effectively. This can alleviate related conditions such as incontinence.

Are there different types of vaginoplasty?

A basic cosmetic vaginoplasty procedure can take as little as an hour to complete. However, for more serious problems, more complex versions of the surgery are required. Intestinal This procedure involves the use of a section of the sigmoid colon to create a new vaginal wall. This type of vaginoplasty can be performed laparoscopically. Peritoneal Also referred to as the "luohu operation", a peritoneal vaginoplasty uses the lining of the abdominal cavity to create a new vaginal wall. This laparoscopic procedure carries a risk of fistula, but it removes the need to use a dilation device after surgery. McIndoe Rather than using lining from the abdomen, the McIndoe technique involves the use of a skin graft. The graft is first placed on a mold, and then inserted into the vagina. But, because the skin isn't self-lubricating, women who undergo this procedure need to use a dilation device regularly for the rest of their lives. Buccal mucosa Buccal mucosa is a natural tissue that is produced in the lining of the mouth. It's quite similar to the lining of the vagina, which makes it suitable for a very specific type of vaginoplasty. However, this type of procedure is relatively rare, as the tissue available for relocation is limited. Penile inversion Penile inversion vaginoplasty is used in gender affirmation surgery. Skin from the outside of the penis is removed, and then turned inside out to create the lining of the new vagina. The penis head is used to create a clitoris, and the skin on the scrotum is utilised to create the labia. Labiaplasty Labiaplasty isn't a type of vaginoplasty, but it's worth discussing it in this context. Some surgeons will perform both procedures at the same time. Labiaplasty surgery reduces and reshapes the skin flaps on either side of the vagina's opening (the labia minora).

What should I expect?

• The success rate associated with vaginoplasty is very high. However, reconstructive forms of the procedure aren't quite as successful. Nevertheless, the chances are you'll get the results you're looking for.

• You will probably feel some pain and discomfort at the incision site for several days after the procedure. You might be prescribed pain-relief to aid your recovery. And your surgeon might recommend reducing pain and swelling with ice packs.

• You should plan to be unavailable for heavy domestic or work duties for at least four weeks after surgery. However, there's a good chance you'll be ready to return to a reasonably normal life in a fraction of that time. Nevertheless, you could be asked to attend outpatient appointments for up to a year after the procedure.

• Depending on your circumstances, your surgeon may advise a general anaesthetic for the procedure. If this is the case, you might need an overnight stay in a hospital or clinic.

After two or three days, you should be able to walk around normally - albeit slowly. Most patients are able to resume a normal sex life relatively quickly after the procedure, but be sure to progress at your own pace.

Risks and serious side-effects are rare. However, it's always best to be aware of them before you undergo a vaginoplasty. If, for example, you suffer a prolapse or chronic bleeding, you may need further treatment. You may also need to prepare yourself for a longer-than-expected period away from work or domestic duties.