Vaginectomy

Transmasculine Genital Reconstruction Surgery Decision Aid

Description and Summary of Surgery

Pre Op Requirements?

Hyst/BOO

WPATH a part of process

When is it done?

You have to have the hysterectomy (removal of uterus) and removal of ovaries prior to vaginectomy.

How is it done?

Vaginectomy requires 

  1. Going to sleep under general anesthesia 

  2. Removal of the lining of the vagina

  3. Closure of the vaginal opening. 

Recovery?

You typically will stay in the hospital 1-3 days following the surgery 


Below are anatomical diagrams illustrating before the vaginectomy surgery and after the surgery.

Screen Shot 2021-04-07 at 9.45.52 AM.png
 

Description of image to left.

Outcomes/ Pro, Cons, Risks

 

Pros

A vaginectomy will lead to:

A ~60% lower risk of urethral stricture (narrowing of the pee tube) and fistula (connection between urinary tract and the outside world or other organs) if you have a penis created with urethral lengthening{Al-Tamimi, 2018 #12293}

A smooth perineum from anus to scrotum 

Fewer gynecologic organs 

Lower risk of cancer or other problems with the vagina


Cons

A vaginectomy is:

Irreversible

Must have a hysterectomy / ovary removal prior to or with vaginectomy 

No longer able to become pregnant 

Unable to have penetrative vaginal intercourse


Risks

A vaginectomy can lead to:

Injury to the rectum/bowel/intestines (requiring bowel diversion/stoma) (~1-2%)

Injury to the urinary tract (?%)

Need for repeat procedures (?%)

Anesthetic risks 


 

Outcomes/ Pros, Cons, Risks

 

Pros

 

A vaginectomy will lead to:

A ~60% lower risk of urethral stricture (narrowing of the pee tube) and fistula (connection between urinary tract and the outside world or other organs) if you have a penis created with urethral lengthening{Al-Tamimi, 2018 #12293}

A smooth perineum from anus to scrotum 

Fewer gynecologic organs 

Lower risk of cancer or other problems with the vagina

 

Cons

 

A vaginectomy is:

Irreversible

Must have a hysterectomy / ovary removal prior to or with vaginectomy 

No longer able to become pregnant 

Unable to have penetrative vaginal intercourse

 

Risks

 

A vaginectomy can lead to:

Injury to the rectum/bowel/intestines (requiring bowel diversion/stoma) (~1-2%)

Injury to the urinary tract (?%)

Need for repeat procedures (?%)

Anesthetic risks