An Overview of Neovaginal Reconstruction Options in Male to Female Transsexuals

Abstract

Transsexualism is a complex condition in which the person experiences the inconsistency between the desired gender and their biological gender. Absence of the vagina is devastating in male to female transsexuals. Creation of the neovagina is the main surgical problem in these patients. Historically, beginnings of the neovaginal creation have their roots in the treatment of Mayer-Rokitansky syndrome and conditions such as cloacal anomalies, certain intersex disorders, vaginal malignancies, or severe vaginal trauma, but have more recently found great purpose in male to female sex reassignment surgery. Many operative procedures have been described but none is ideal. Therefore, the search for new, improved solutions continues. In neovaginoplasty reconstruction of the vulvovaginal complex is performed in its entity. The gold standard in neovaginal reconstruction in male to female sex reassignment surgery is penile skin inversion technique with or without scrotal flaps, which enables adequate sensation of the neovagina, good neovaginal depth, good erotic sensitivity of the neclitoris, and esthetically acceptable labia minora and maiora.

Sex reassignment surgery

“…Using the part of the sigmoid colon, we can create a neovagina of adequate depth that will satisfy the patient. Due to the characteristics of the sigmoid colon, neova gina is self lubricating, has thicker walls and therefore is more resistant to trauma in comparison to the segment of the small intestine [22,23]. In the postoperative treat ment, neovagina does not require long term dilation, like in penile inversion vaginoplasty, except the dilatation of the introitus to prevent stenosis.…”

Razvoj pola

“…Trans seksualna osoba se oseća kao žena zarobljena u telu muškarca ili muškarac zarobljen u telu žene [58]. Te oso be često traže da im se hirurškim zahvatom promeni pol [59,60]. Beograd je trenutno jedan od vodećih svetskih centara za tu vrstu medicinskih zahvata.…”

Anatomy of genital reaffirmation surgery (male‐to‐female): Vaginoplasty using penile skin graft with scrotal flaps

“…The prevalence of male‐to‐female transsexuals in the general population is 1:7400 to 42,000 (Bizic et al, ), a threefold annual increase being reported as gender dysphoria becomes increasingly accepted in modern society (Colebunders et al, ). Sex reaffirmation surgery (SRS) is typically the last step in transitioning to the preferred gender after clinical diagnostic assessment, psychotherapy, and hormonal supplementation (Horbach et al, ).…”