Penile inversion Vaginoplasty

Penile inversion vaginoplasty is the most common surgical technique for gender-affirming genital reconstruction is trans-feminine individuals. This technique uses primarily genital skin to construct the vulva and neovagina for patients assigned male sex at birth. But the point is that not all trans people are not benefitting from penile inversion. To be able to perform a penile inversion vaginoplasty, the trans-gender must have a penis with minimum dimensions which means it must measure more than 12 centimeters stretching the skin of the penis and counting from the penopubic angle to the tip of the foreskin. Also, it depends the quality of the penile skin. In any case, it will always be the surgeon who will assess all the circumstances, as well as the person’s medical history and the suitability of the technique to be used in their case.

Stopping the Hormone Therapy: Most of the people who undergo surgery such as vaginoplasty are treated with estrogens and anti-testosterone drugs. Taking estrogen carries a risk of deep vein thrombosis during surgery. For this reason, estrogens are quit about one month before the operation. As for anti-testosterone drugs, experience has shown that withdrawal is not necessary. They can be maintained until the operation. Their total withdrawal will be one or two weeks after the vaginoplasty.it is essential to make an appointment with the endocrinologist before and after surgery and that you follow their instructions.

The operation itself usually lasts from three to five hours plus the process of anesthesia, preparation of the patient and the recovery immediately after surgery. This surgery is always performed under general anesthesia, but in some exceptional cases it is performed under spinal anesthesia.

The operation begins by opening the penis with a midline incision leaving the corpora cavernosa and vascular nervous pedicle visible. Part of the glans will be used to form the clitoris, while most of the penile skin is repositioned to form the vaginal walls. The remaining penile elements comprising the corpora cavernosa (whose function is erection) and part of the penile urethra are removed. The urethra or urinary tract is shortened and redirected to emerge in its normal position; that is, just above the new vaginal opening or introitus. Excess erectile tissue around the urethra is removed in part to prevent it from increasing in size during sexual arousal and preventing the vagina from opening properly.

The spermatic cords are clove and the testicles are removed, although the surrounding scrotal skin and skin from the surrounding areas will be used to form the labia majora and labia minora. In some cases, the residual scrotum is used to form a tube of skin that is added to the end portion of the penis to increase the vaginal depth by a few centimeters.

The anatomical space where the vagina will be placed is between the urinary bladder and the rectum which is end of the large intestine. This is the most technically complicated part. Once the space where the vagina will be located has been formed, the penile skin is placed inverted to form the vaginal walls. The vaginal depth will depend on each patient and the elements that determine it.

The next stage of the surgery is to reconstruct the clitoris. This is done with the portion of the glans that has been preserved, along with its nerves and blood vessels, in order to maintain sensitivity and the capacity for full sexual satisfaction. The clitoris will be attached above the urethral meatus and a hood will be made to cover it.

The penile inversion vaginoplasty surgery is complete after reconstruction of the labia: part of the skin of the scrotum turns into the labia majora and, if there is extra skin, two additional folds can be formed to imitate the labia minora and a clitoral hood. In most cases, the whole surgery can be done in a single operation, but in some special cases, vaginal aesthetic surgery can be put off until the second operation.

Compressive bandages are then applied, and the patient will use a bladder catheter for approximately two weeks.

The bladder catheter is maintained until the tenth day or until periurethral inflammation is minimal, so the patient will be discharged with this catheter. You will handle the indicated dilations at home and the treatment prescribed by the analgesia and antibiotic therapy physician.

A member of the medical team will tell you how to avoid possible complications and what to do if they should arise. If you have any doubts or anomalies after the operation, you should consult your doctor so that he or she can diagnose and provide a solution.

Some of the common complications after this surgery are as follows:

• Bleeding
• Pain
• Clitoral complications
• Urinary complications