Vaginoplasty

Vaginoplasty is a surgical intervention used to build or rectify the structure of the Vagina. It serves multiple purposes, including addressing medical concerns like Vaginal damage resulting from childbirth and complications related to pelvic floor diseases. Additionally, it can be employed to create a transgender Vagina, which plays a crucial role in gender affirmation.

Why is Vaginoplasty needed?

• Congenital conditions that may necessitate vaginoplasty encompass:
• Vaginal agenesis, as seen in cases like Rokitansky syndrome
• Vaginal atresia, which can occur due to conditions such as a transverse vaginal band, imperforate hymen, or atresia affecting the lower one-third of the vagina
• Intersex conditions like androgen insensitivity syndrome, congenital adrenal hyperplasia, and gonadal dysgenesis
• As a choice in transgender individuals who are undergoing gender affirmation surgery

Acquired conditions that might require this treatment include:

• Extensive surgical procedures for pelvic tumors or abscesses that necessitated exenteration
• Various types of trauma
• Vaginal prolapse or other weaknesses in the pelvic floor
• Vaginal laxity that may result from childbirth, trauma, or the natural aging process

Pre-evaluation for Vaginoplasty is a collaborative process between the patient and the surgical team, with the goal of ensuring the procedure is both safe and aligned with the patient's desired outcomes. It's essential for patients to be open and honest during this evaluation to receive the best possible care and achieve their goals. Before surgery, you go through a series of evaluations and examinations. These assessments may encompass:

• A physical examination to gauge your overall health and gather information about your medical background.
• Educational sessions for patients to gain insight into the potential risks, advantages, and post-surgical care obligations.
• Guidance on actions that can reduce the likelihood of complications, such as quitting smoking. This is because smoking can impair healing and increase the risk of complications.
• For transgender women seeking vaginoplasty as part of their gender affirmation journey, there are additional preoperative prerequisites, including the removal of genital hair and compliance with the criteria established by the World Professional Association for Transgender Health.
• For transgender women, the use of hormone therapy may be evaluated. Hormone therapy can impact the genital tissue, and the surgeon needs to consider its effects on surgical outcomes.
• Patients are required to provide informed consent, indicating their understanding of the procedure, potential risks, and their willingness to proceed with surgery.

The surgical objectives of Vaginoplasty vary depending upon the reasons of Surgery.

When performed to address post-childbirth injuries, the procedure typically involves:

• Excising surplus skin.
• Employing sutures to secure lax tissue, either partially or throughout the depth of the vagina.
• Reducing the vaginal opening size.

To correct congenital defects present from birth, the procedure may encompass:

• Constructing a functional vagina.
• Removing excessive tissue or irregular structures.
• Preventing the accumulation of blood during menstruation.

As a part of gender affirmation surgery, the procedure may encompass:

• Partial excision and reconstruction of male external genitalia. The penile and scrotal skin is utilized to craft a vaginal canal and labia.

The steps involved in vaginoplasty surgery are:

1.The patient is administered general anesthesia to ensure they are unconscious and pain-free during the procedure.

2.There are different surgical approaches to vaginoplasty, and the choice depends on factors such as the patients anatomy and the surgeons; preferences. Common approaches include:

• Intestinal Vaginoplasty (or Sigmoid Vaginoplasty)
• Abdominal Vaginoplasty (or Peritoneal Vaginoplasty)
• Abdominal Skin Graft (McIndoe Vaginoplasty)
• Buccal Cavity Mucosal Vaginoplasty
• Inverted Penile Tissue Vaginoplasty

3.The surgeon reshapes the tissue to create the vaginal canal and labia. The depth and dimensions of the vagina are customized to match the patients preferences and needs.

4.The surgical team carefully closes the incisions with dissolvable sutures to ensure a secure and clean closure.

5.After the surgery, the patient is monitored in a recovery area before being transferred to a hospital room. Post-operative care includes pain management, wound care, and monitoring for any potential complications.

Complications following Vaginoplasty to address injuries from childbirth may involve:

• Dyspareunia (discomfort during intercourse).
• Numbness or diminished sensation.

Complications associated with Vaginoplasty for gender affirmation may encompass:

• Vaginal stenosis (narrowing of the vaginal canal)
• Insufficient vaginal depth
• Vesicovaginal fistula (an unusual connection between the vagina and urinary tract) or rectovaginal fistula (an unusual connection between the vagina and rectum)
• Nerve damage
• Unsatisfactory cosmetic outcome

The duration of recuperation after vaginoplasty may vary among individuals, but as a general guideline, a complete recovery can typically be expected within six to eight weeks post-surgery. Nevertheless, many patients find themselves able to resume their usual daily activities within a few days after the operation.

Patients may experience a range of symptoms during the days and weeks following the surgery. These symptoms may encompass swelling, tenderness, bruising, and some discomfort in the treated area. Post-operative symptoms may also include discharge and minor bleeding, which are typically regarded as normal in the immediate aftermath of the procedure. However, should you notice an unusual or excessive amount of bleeding, it is highly recommended that you promptly get in touch with your healthcare provider.

Like any form of vaginal surgery, its crucial not to exert yourself excessively during the initial days following vaginoplasty. Its essential to stay mobile after the procedure and maintain proper hydration to aid in the healing process. Nevertheless, its equally vital to ensure you receive adequate rest to promote optimal healing after vaginal tightening.

You can begin gentle cleansing approximately two days post-surgery, but it's crucial to be gentle and avoid rubbing the area to prevent potential wound disruption. Additionally, it's advisable to steer clear of using soaps or other topical products, as they could heighten the risk of fungal infections. For the initial four weeks after the procedure, its recommended to refrain from taking baths, which includes avoiding saunas, steam rooms, and Jacuzzis for a minimum of eight weeks.

Several physical activities, like cycling or running, should be refrained from for the entire six-week recovery period, as engaging in these activities may lead to irritation of the vaginal area.

Dilation plays a crucial role in the recovery process. Patients will receive dilators along with instructions for their use during the postoperative period particularly in transgender care.

Strict adherence to the dilation routine plays a pivotal role in promoting healing and preserving both the depth and width of the vagina. Following the initial healing phase, it's imperative to continue regular dilation for at least one year post-surgery. Given that the vagina lacks a mucosal lining, routine cleaning with soapy water or douching should suffice to maintain hygiene. Initially, daily douching is advisable during frequent dilation sessions, but this frequency can be reduced to 2-3 times a week as dilation becomes less frequent. In cases where odor or discharge persists, a thorough examination should be conducted to identify any lesions or granulation tissue. Using a solution of vinegar or a 25% povidone-iodine mixture in water for 2-3 days may help address overgrowth or imbalance of flora, after which a return to regular soap and water cleaning is recommended. If drainage and odor persist, a 5-day course of vaginal metronidazole may be considered.

It may be prudent to consider an annual visual pelvic examination to screen for lesions, granulation tissue, or any unintended loss of depth and width, even though there is no concrete evidence supporting this recommendation. Since the vaginal lining is akin to skin, there is a potential risk of developing skin cancers like squamous cell carcinoma, basal cell carcinoma, or melanoma, which can also affect the vaginal area and should be treated similarly. In cases where warranted, an endovaginal prostate examination may be performed, as the rectal approach may be obstructed by the newly formed vaginal walls.

The majority of women report a high level of satisfaction with the surgical outcomes, often experiencing enhanced sexual function and pleasure following vaginoplasty. The primary method in transfeminine (TF) genital reassignment is typically penile inversion vaginoplasty, as described in various studies. Alternative techniques, such as sigmoid vaginoplasty, have also been explored in medical literature but are generally considered less favorable compared to penile inversion. In the available literature, penile inversion procedure generally demonstrates an overall technical and subjective success rate ranging from 80% to 90%. The complication rate for penile inversion is commonly estimated at around 20% to 30%, whereas alternative procedures tend to have a higher complication rate, typically falling within the range of 35% to 60%.

The cost of Vaginoplasty in India spans from approximately Rs 39,894 ($501) to Rs 49,847 ($626), with an average fee of Rs 44,831 ($563).

The cost of Vaginoplasty in India is generally more affordable than in numerous Western nations, while still maintaining world-class quality. Following data can give you a peep into the international cost comparisons for this treatment.

Following are the factors affecting cost of Vaginoplasty in India:

• Out of pocket expense
• Health insurance coverage
• Consultation fees
• Pre Surgical expenses
• Surgery cost
• Hospital fees
• Doctor fees
• Patients age
• Objective of surgery
• Type of surgery
• Overall health status of the patients
• Complications involved after the surgery
• City where hospital is located

The expenses for diagnostic tests and evaluations linked to vaginoplasty can fluctuate due to several factors. These factors encompass the particular tests needed, your choice of healthcare facility or clinic, and your geographical location. These diagnostic evaluations may encompass pre-operative assessments, imaging examinations like CT scans or X-rays, blood tests, and other evaluations aimed at confirming your suitability for the surgery and facilitating effective procedure planning. The approximate cost of diagnostics for vaginoplasty is INR 2000-4000.

MedFlick, your trusted healthcare companion, is dedicated to ensuring that your medical journey goes as smoothly and successfully as possible.

• Individualized Guidance: Personalized guidance throughout your medical journey.
• Access to a broad network of prominent hospitals, top doctors, and skilled surgeons.
• Transparent and Competitive Pricing: A full breakdown of treatment costs that eliminates surprises and offers you cost-effective solutions.
• MedFlick provides everything from travel arrangements to hotel and visa help to lodging.
• Multilingual Support: Breaking down language barriers to allow patients and medical professionals to communicate more effectively.
• The road to a successful vaginoplasty is long and winding, full of hope, resilience, and the promise of a brighter future. With MedFlick as your guide, navigating this life-changing adventure becomes simple and liberating.