Frequently asked questions about MTF vaginoplasty

TRANS VAGINOPLASTY SURGERY

Colovaginoplasty is typically recommended when the penile inversion technique cannot provide sufficient vaginal depth (common in cases of circumcised individuals, previous genital surgeries, or small penile size). Despite its complexity, colovaginoplasty often achieves excellent results, including a deeper neovagina with natural lubrication due to the use of a segment of the colon, which mimics the texture and moisture of a cisgender vagina.

However, colovaginoplasty involves a higher level of surgical complexity and carries increased risks. Therefore, it is usually reserved for cases where penile inversion is not viable. Ultimately, both techniques can deliver functional, aesthetically pleasing results, but the choice of method should be based on your anatomy and health needs as assessed by your surgical team.

As with any surgery, there are always risks involved. A member of the medical team will provide guidance on how to avoid potential complications and how to act if any issues arise. If you experience any concerns or abnormalities after the surgery, you should consult your doctor so they can diagnose the issue and offer a solution. To assist you, a 24-hour phone line will be available, along with a follow-up email for any questions or concerns.

Many trans women report a significant improvement in their emotional and mental well-being following vaginoplasty. The procedure can reduce gender dysphoria and increase confidence, helping you feel more aligned with your gender identity. However, it’s essential to understand that emotional healing, like physical healing, takes time.

SENSITIVITY

Yes, most women retain or even enhance their sensitivity following vaginoplasty. During the surgery, structures like the glans are preserved and reshaped to form the clitoris, allowing for the preservation of erogenous sensitivity.

It’s important to note that each body heals differently and the rediscovery of sexual pleasure may take time. Some women experience a gradual improvement in sensitivity and orgasmic capacity as they become more familiar with their new anatomy.

It’s recommended to wait at least three months before attempting penetrative sexual intercourse, allowing sufficient time for healing and for the vaginal tissue to strengthen. Engaging in sexual activity too soon can lead to complications such as tearing or infection. Always follow your surgeon’s guidelines on this matter.

Your first experience of penetrative sex may feel different, so it’s important to be gentle and ensure that your partner is aware of your needs. Vaginal dilations prior to intercourse can help prepare the neovagina for penetration and reduce discomfort.

It does not have as abundant natural lubrication as a vagina resulting from birth. But over time, the epithelial lining of the neovagina adjusts to the warmer internal environment. In about 40% of cases, some degree of spontaneous lubrication is achieved. For those who do not experience sufficient lubrication, using intimate moisturisers or water-based lubricants during sexual activity is recommended.

POST-OPERATIVE CARE AND RESULTS

Recovery from trans vaginoplasty is a gradual process that takes months. Most patients remain in the hospital for around a week after surgery to monitor for any immediate complications. You will likely have a catheter in place for the first 10-14 days to assist with urination, and your surgeon will give detailed guidance on wound care and hygiene practices

Dilation will begin shortly after surgery. You will be provided with the necessary tools and instructions. It’s important to attend all follow-up appointments at 3 weeks, 3 months, 6 months and 12 months after surgery to ensure optimal healing and to address any concerns.

Dilations are a very important part of the whole treatment. Their constant and methodical practice during the first three months is strictly necessary. After this period, sexual intercourse can begin and natural penetration is considered better than mechanical dilation.

The time required will depend on the sport you wish to do. It is preferable to consult your surgeon beforehand. At IM GENDER we provide a list of the most common sports and the approximate indicative waiting time.

Hormone treatment is necessary for life, but the doses will be modified downwards according to post-surgery checks and your age. This modification must always be carried out under the supervision of an endocrinologist. Self-medication can put your health at risk.

While a post-vaginoplasty neovagina does not require routine gynaecological examinations in the same way as a cisgender vagina (due to the absence of a uterus, cervix or ovaries), it’s still important to monitor your health. Any symptoms should be assessed by your surgeon or a healthcare professional familiar with post-surgical care for trans women.

Yes, even after MTF vaginoplasty, the prostate remains in place, although it usually shrinks over time due to hormone therapy. While the risk of prostate issues, such as cancer, is practically zero, it’s still advisable to have your prostate checked as part of your routine healthcare, especially after the age of 50. A PSA (Prostate-Specific Antigen) test may be recommended to monitor for any changes.

The results of vaginoplastyare generally very satisfactory, both aesthetically and functionally. Most patients report improved quality of life, greater self-esteem and higher satisfaction with their bodies.The neovagina created during the surgery typically resembles a cisgender woman’s vagina in appearance and, in many cases, patients are able to enjoy sensitivity in the clitoris and labia. However, it’s important to have realistic expectations, as results can vary based on the surgical technique used and individual anatomy.