Vaginoplasty

During vaginoplasty surgery, Dr. Boonipat will make a tunnel between your rectum and prostate that becomes the new vagina. He lines the inside of the tunnel with skin from the scrotum, the penis or both. If there’s not enough penile or scrotal skin, Dr. Boonipat might take skin from another area of the body and use it for the new vagina as well. 

Orchiectomy: 

• Surgery to remove the testicles. 
• May eliminate the need for testosterone blockers and reduce estrogen requirements. 
• Typically performed as an outpatient procedure or together at the time of vaginoplasty. 
• Involves making an incision in the scrotum to remove the testicles. 
• Often part of vaginoplasty, but can be performed independently. 

Vaginoplasty: 

• Surgical creation of a vagina using skin from the penis and scrotum (penile inversion). 
• May include labiaplasty (creating labia) and clitoroplasty (creating a clitoris). 
• Alternative techniques use skin from other body areas or tissue from the colon (bowel flap). 
• Testicles are removed if not already done. 
• We destroy hair follicles during surgery so electrolysis sessions prior to surgery is not required.  
• Post-surgery, a catheter is placed in the urethra for several days; recovery can take up to two months. 
• Vaginal dilators are used to maintain and stretch the vagina; long-term use is required. 
• Patients need to dilate multiple times per day, usually indefinitely in order to maintain the vaginal canal.  
• Prostate cancer screening is still necessary since the prostate gland remains.  
• What to expect with dilation: Video from Mayo Clinic of one of the case Dr. Boonipat was involved with while he was there. 

Results: 

• Gender-affirming surgery can improve well-being and sexual function. 
• Following your healthcare provider’s advice for long-term care is crucial. 
• Continued post-surgery care is linked to better long-term health outcomes.