Reminder for preparing for colporrhaphy

History of the operation

Dr. Harry Benjamin

Vaginoplasty is a change of gender from male to female, or vice versa. The first operations of this kind began to be carried out in Europe in the 50s of the 20th century. At that time, skin grafted from the thighs and buttocks was used to create vaginas. The operations had many disadvantages. They left behind numerous scars; the skin might not heal. In addition, sensitive tissue was removed, which led to difficulties in obtaining sexual pleasure and the inability to experience orgasm.

The new technology of vaginoplasty, on the basis of which operations are carried out today, was developed by Georges Bureau in the 60s of the last century. It involves the formation of female genital organs from the skin of the scrotum and penis. This technology has several important advantages: vaginoplasty for men is carried out in one stage, the number of scars is minimal, additional painful skin grafting operations are not required, and the ability for sexual satisfaction is preserved.

This technology was discovered by Buro only in 1973. Dr. Harry Benjamin, who was an American physician who pioneered the study of transsexuality, began systematically referring his patients to Dr. Buro after the discovery of this surgical technology. Today, it has been significantly improved both in terms of maintaining tissue sensitivity and in terms of aesthetics. In 1978, a community of surgeons specializing in plastic surgery of intimate organs was founded in America.

Indications for vaginoplasty

Situations in which surgery is required:

• Increased degree of stretching of the vaginal opening;
• Excessive vaginal size;
• Weakness of the vaginal muscles and the threat of uterine prolapse;
• Postpartum trauma.

The most serious medical reason for surgery is the displacement of the vagina and uterus from their anatomical position. This situation occurs when there is a critical decrease in muscle tone and stretching of the ligaments responsible for holding the uterus.

The initial stage of vaginal prolapse is manifested by the characteristic appearance of the organ. If treatment is not carried out, the disease will develop, which will lead to enuresis (urinary incontinence), prolapse of the uterus and other internal organs, and difficulty walking.

The later stages of the disease are accompanied by severe pain. There is a danger of infection entering the genitourinary tract and the development of serious inflammatory reactions. The risk of injury to internal organs in contact with underwear and skin increases.

The main contingent of patients with this diagnosis are women over 50.

Aesthetic indications for vaginoplasty are a decrease in the intensity of sensations during intimacy and dissatisfaction with sexual life.

Basically, this situation occurs after childbirth, when the size of the vaginal opening and the organ itself increase for physiological reasons. Anterior and posterior plastic surgery reduce the size of the vagina and restore sensitivity.

Difficult childbirth often leads to tears in the outer covering, which requires emergency suturing of wounds. After this, unsightly scars remain, which can be eliminated with the help of modern vaginoplasty and plastic correction of the labia.

Indications and contraindications for plastic surgery

Plastic surgery of the genital organs is performed for the following indications:

• Transsexualism;
• One year of hormonal therapy prior to surgery;
• Two years of observation by a psychiatrist;
• Obtaining a certificate with the appropriate diagnosis.

Gender change from male to female

Contraindications to gender reassignment:

• Transsexualism was not detected;
• Mental illnesses;
• Homosexuality;
• Alcoholism;
• Minority;
• Elderly age;
• Genetic diseases;
• Drug addiction and other possible individual indications.

Demand for these operations

Each country has its own statistics on plastic surgery of intimate organs:

• America. There is one case of transsexualism in men and 0.25 in women per 100,000 people;
• Singapore. There are 35 cases of transsexualism per 100,000 people;
• England. Over 10 years, 853 operations were performed on men, 12 on women;
• Thailand. Still ranks first in such operations.

World statistics: per 100,000 population there are 1-2 cases of transsexualism.

An interesting fact: if in Western countries plastic surgery of the genital organs is in great demand among men, then in Russia for every 1 case of transsexualism in a man there are 3-4 cases of transsexualism in women.

Cost of gender reassignment surgery

After female to male gender reassignment surgery

The price of gender reassignment varies depending on the country:

• Thailand. This country is the most developed in terms of genital plastic surgery. This is already a separate direction of tourism with all the amenities: a luxury hotel, consultations with the best doctors, surgery and rehabilitation procedures. The estimated price of gender reassignment in Thailand is 7-10 thousand dollars;
• Russia. The cost of psychiatric consultations is approximately 15 thousand rubles, operations – 550 thousand rubles. In Russia, relative to other countries, there is a lack of specialized training and equipment, which is why people usually choose to travel abroad for a gender change;
• America. The price of the main stage of the operation is 40 thousand dollars. The cost of removing a breast is 4 thousand dollars, shaping the penis is 7 thousand dollars, closing the vagina or enlarging the urethra is about 4 thousand dollars;
• Austria. All stages of gender reassignment will cost 13-20 thousand dollars.

Before plastic surgery of intimate organs, hormonal therapy is required for a year.

Consequences of the operation

Of course, during the rehabilitation period the patient is likely to encounter some adverse consequences of vaginal plastic surgery. After the operation, pronounced swelling of the genital organs is noticeable, pain or bruises may appear. Severe swelling usually goes away within the first two weeks of the recovery period. This consequence completely disappears on its own after about two months. Painful sensations in the lower abdomen also disappear quite quickly, namely in two to three weeks. The pain is usually of moderate intensity, so painkillers may be needed.

Subcutaneous bruises do not require additional treatment unless they grow and are not accompanied by pain. In the latter case, you must definitely consult a doctor. The pelvic organs are well supplied with blood, so sudden bleeding can lead to significant blood loss.

Stages of the operation and its features

Before the operation you must:

• Observation by a psychiatrist for two years;
• Hormone therapy for a year;
• Register with the psychiatric department;
• Pass a special examination;
• Pass a commission to identify transsexualism.

Chastity Bono changed her gender to male

Stages of gender reassignment in men

• Orchiectomy. The testicles are removed, resulting in a reduction in testosterone production in the body;
• Feminizing vaginoplasty. There are several technologies for performing this operation. Most often, female genital organs are created from the tissues of the penis. It is possible to use a vagina made of silicone or other fillers;
• Mammoplasty with implantation of breast prostheses.

Possible additional operations:

Model Lea T is a former man

• Buttock surgery;
• Removal of Adam's apple;
• Waist surgery;
• Facial plastic surgery.

Stages of gender reassignment in women

• Mastectomy. The mammary glands are removed. At the same time, the nipple is preserved;
• Phalloplasty. Creation of a penis from tissues of the labia or body tissues;
• Uterus removal.

Possible additional operations:

• Building muscles, chin;
• Liposuction;
• Facial plastic surgery.

What is laser vaginoplasty

Laser vaginoplasty is a new non-invasive method of treating vaginal laxity syndrome. Like intimate filleting, this manipulation can effectively combat sexual dysfunction in women.

The video below will tell you what laser vaginoplasty is:

Concept

Laser vaginoplasty is a minimally invasive procedure that allows narrowing and tightening of vaginal tissues with minimal risks of complications. It is based on photothermal interaction of mucosal surface tissues with a laser. Warming the tissue leads to an increase in collagen production, which increases strength and elasticity.

In parallel, in addition to tissue contraction, the laser causes a long process of collagen reconstruction, which ultimately leads to rejuvenation. That is why this procedure is also called intimate lifting.

Kinds

There are no types of this procedure. It is carried out using one generally accepted technology, which is the most optimal.

Indications

Indications for the use of this type of plastic surgery are:

• Tissue atrophy;
• Vaginal atony;
• Decreased elasticity and sensitivity of the female genital organ;
• The need to restore the reproductive tract in women after childbirth;
• Prevention of vaginal relaxation syndrome;
• Increased tone;
• Getting rid of stress urinary incontinence syndrome.

Contraindications

Contraindications are:

• Diabetes;
• Oncological diseases;
• Pregnancy;
• Prolapse of the 3rd degree of the pelvic organs with complete or partial prolapse of the uterus;
• Infectious diseases;
• Hemorrhagic diathesis;
• STD;
• Infectious diseases (including tuberculosis of any localization, influenza, seasonal acute respiratory infections);
• Heart failure (with shortness of breath);
• Arterial hypertension;
• Tendency to develop hypertrophic scars;
• Arrhythmia;
• Inflammatory acute pathologies of the pelvic organs;
• Herpes in the acute stage.

Comparison with similar techniques

There are certain types of manipulations in the intimate sphere on the market, which are designed to improve the quality of sexual life and improve health. In comparison with skin grafting, laser plastic surgery has a significant advantage.

• If we take the use of hormonal drugs and special exercises, then the latter have significant limitations in effectiveness. With the help of laser vaginoplasty, it is possible to achieve the best results in a short time. The duration of the effect is approximately 1 year.
• Surgical procedures can bring better results, but also have significant risks. At the same time, there is a risk of reducing the sensitivity of the tissues of the genital organ, which literally has the opposite effect. In addition, a long rehabilitation period is required. But surgical manipulations have a very long period of effectiveness.
• Therefore, laser vaginoplasty is the golden mean between therapeutic, medicinal methods and surgical intervention. An analogous result is intimate filling.

Before and after laser vaginoplasty

After operation

Rehabilitation after sex reassignment surgery includes:

Before and after gender reassignment to female

• Daily vaginal douching;
• Weekly lubrication of the vagina with Levomekol ointment;
• Daily lubrication of seams with Solcoseryl ointment;
• Taking probiotics to restore the microflora of the gastrointestinal tract;
• Daily stretching of the vagina using your fingers.

Additional prohibitions and recommendations during rehabilitation after sex reassignment surgery:

• You can have sex 1.5 months after discharge. Be sure to use special lubricants and condoms;
• You cannot sit for three weeks after leaving the hospital. It is possible to gradually develop physical activity and sit down only from the fifth week after discharge;
• Squatting is not allowed for 6 months after discharge. Physical activity should also be avoided.

Your doctor will give you more detailed recommendations taking into account your individual characteristics.