What Happens During a Penile Inversion Vaginoplasty? - New York City

What Happens During a Penile Inversion Vaginoplasty?

This is changing a man into a woman surgery.

If you’ve ever gotten surgery of any form, you’ve probably wondered about that spookiest of questions: What’s happening to you when you’re unconscious, under the surgeon’s knife? Of course, the answer varies per operation. So let’s bring it a bit closer to home: What happens to you during a penile inversion vaginoplasty? We offer this information, not to make things scarier for you, but to make them less scary. In fact, once you understand this procedure, you’ll hopefully understand that there’s really very little to fear about a vaginoplasty.

Your last conscious thought, if the surgeon puts you completely under, will be the administering of the anaesthetic. After this, the urethra will be catheterized, and then the surgeon will make an incision to the resulting open area at the penis base. After this, the urethra will be freed and sometimes shortened.

Depending on the surgeon, she might retain the small urethra section so that she can later incorporate it into the vulva, where it will serve as a lining between the clitoris and the urethral opening. Many surgeons find that it provides a more authentic finish for the skin texture in the area. Many patients also report that it’s responsible for some vaginal lubrication, however, most doctors feel that it’s not significant.

Next, after the corpus cavernous are identified, they are removed. This is a critical part of the procedure, since a failure to do it right could result in an undesirable swelling in the vaginal area during times of arousal. Then castration (technically an “orchiectomy”) is performed.

Next, the surgeon prepares a vaginal cavity, being careful not to cause any damage or perforate the patient’s colon, which is nearby. To do so could significantly extend the recovery period.

The surgeon then uses the penile skin that was taken earlier to form a closed tube. If the surgeon feels it’s necessary, more tissue is added to create a vaginal cavity of adequate diameter and length. She will get this additional skin from donor sites such as the abdomen or scrotum.

After the surgeon has successfully prepared the vaginal cavity, the tube is turned inside-out and then inserted in order to form then neo-vagina. The surgeon then takes skin from the scrotum and the areas around the neo-vagina entrance to form into the labia majora and labia minora. The shortened urethra is then sewn in place between the clitoris location and the vaginal opening.

The neo-clitoris is created from a part of the glans (or if the surgeon prefers, other penal areas). It’s positioned above the vaginal entrance.

Once all of this is done, the surgeon will close up all of the incisions, leaving a pliable stent in the neo-vagina, ensuring that it retains the desired shape during the early post-op healing phase. A few days of rest will be needed for the patient following this procedure.

There is one variation to the procedure we described above, in which the surgeon incorporates the penile graft within the vagina’s cavity a few days following the initial vaginoplasty. Some surgeons believe a two-stage process like this raises the likelihood that the neo-vaginal graft will survive (even though, regardless of the procedure, there are few instances in which the graft do not survive these days).