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Vaginoplasty is any surgical procedure performed to construct or reconstruct the vagina. This surgery can be performed to treat numerous situations, correcting congenital defects to the vagina, urethra, and rectum. Sometimes, a vaginoplasty is required after vaginectomy for vaginal cancer in order to restore a normal vaginal function and structure. The surgery can be performed to treat babies born with a microphallus. For cosmetic purposes, it may be done to tighten the vagina after childbirth.
Vaginoplasty can also be performed on transgender and non-binary people who are interested in male-to-female (MtF) sex reassignment surgery. In MtF sex reassignment surgery, vaginoplasty is the process in which a surgeon constructs a vaginal cavity between the urethra and the rectum. Vaginoplasty aims to create a vagina from penile tissue.
Before vaginoplasty, you may have congenital defects to the vagina or you want to tighten your vagina after childbirth or you have had a vaginectomy to treat vaginal cancer. After vaginectomy, all of the problems will be addressed, and the structure and function of your vagina will be restored. If you have the procedure as part of MtF sex reassignment surgery, the procedure may complete your transition.
Vaginoplasty may be performed under general or local anesthesia. The anesthesia used for vaginoplasty is mostly determined by the purpose of the surgery.
There a number of different ways to perform vaginoplasty, depending on the purpose of the surgery. If the procedure is performed to tighten the vagina, your surgeon may remove extra skin from inside the vagina and tighten the tissues with strong sutures. Vaginoplasty to construct the vagina, such as for sex reassignment surgery, for women who have had a vaginectomy, or for women who were born without a vagina, several techniques may be offered, including:
Vaginoplasty can be a complex procedure and it may last between 7 and 10 hours. Depending on the reason for your vaginoplasty, you may need to stay in the hospital for 3 to 5 days. The recommended length of stay in Thailand is around 2 to 4 weeks because you need to attend follow-up checkups.
The patient’s recovery time is different and you should be able to move around within 2-3 days. On average, the total recovery period after vaginoplasty takes around 6 to 8 weeks. During this period, do not take a bath or submerge yourself in water and avoid any strenuous activity. Avoid any sexual activity for 12 weeks. Your doctor will give you the detail of your recovery timeline and when you can resume your normal activity.
To speed up your recovery period, it is important that you closely follow the post-operative instruction your surgeon provides. You should always keep your genital area clean and dry. Your surgeon may give you pain medication to help ease discomfort, make sure to take it as prescribed. You may also need to douche one to two times a week using a non-scented vaginal douche.
If you had penile inversion vaginoplasty, your surgeon will give you a vaginal dilator to be used daily at least for a year to maintain the desired vaginal depth. You can use the device as soon as your bandages are removed and your surgeon will give you a dilation schedule.
Remember that you have to wipe or wash the genital area front to back for the rest of your life. This helps prevent infection from the anal region.
Vaginoplasty is safe and has a high success rate. However, as with other surgeries, the procedure carries some risks and complications. These include bleeding, infection, rupture of the sutures, skin or clitoral necrosis, urinary retention, vaginal prolapse, fistulas, ongoing pain, scarring, and permanent changes in sensation.
The alternative to vaginoplasty depends on the reason you have the surgery. If you want to tighten the vagina, you may be able to get similar results through vaginal tightening exercise and a healthy diet plan. For trans-women who do not plan to have deep vaginal penetration, a procedure called orchiectomy can be an alternative. This procedure removes the testicles and reduces testosterone levels.
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