Vulvoplasty

Overview

Vulvoplasty is a gender-affirming, lower body surgery that creates the vulva (including mons, labia, clitoris, and urethral opening) and removal of penis, scrotum, and testes.

Vulvoplasty means you may be able to stop or reduce testosterone blockers or reduce estrogen dose, be able to urinate sitting down and will no longer need to "tuck" genitals. Vulvoplasty is best for people who are not interested in the ability to have receptive vaginal sex or those who don't want to, or are unable to, maintain the rigorous dilation & aftercare regime associated with vaginoplasty.

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Vulvaplasty Procedure

The basic steps in a vulvoplasty are:

. The external genitals (penis & scrotum) and gonads (testes) are removed

. The sensitive erogenous tissue (glans) is made into a clitoris

. The urethra is shortened

. Vulva (including a mons, labia, clitoris and urethral opening) are created using scrotal and urethral tissue

. A temporary urinary catheter is inserted into the bladder

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Vulvoplasty Risks and Complications

Below is a list of some possible complications of this surgery. Please note - this list is not comprehensive and you should have a detailed discussion of risks with your surgeon.

Abscess formation

An abscess is a collection of pus, caused by a bacterial infection. It can be treated with antibiotics or drained by the surgeon

Hematoma

When blood collects in the surgical site, causing pain, swelling and redness. Smaller hematomas can be drained, but larger ones require removal through surgery

Injury To the Nerves or Muscles in Legs

Can lead to numbness or a change of sensation in the skin of the legs. In very rare cases, it can lead to difficulty moving the leg, which needs correction through surgery.

Loss Of Sensation

You may have small areas of numbness. Your ability to achieve orgasm could decrease. Loss of the clitoris is a remote possibility

Unsatisfactory Size or Shape

Outcomes that are quite different from what was expected may require surgical revision.

Urological Complications

Examples include fistulas (flow of urine to areas other than the urethra opening), stenosis (narrowing of the urethra, causing difficulties urinating) and strictures (blockage of the urethra, causing difficulty urinating). It is common to have spraying or dribbling when urinating until your swelling settles down. If these problems don’t resolve on their own, they may require additional surgery.

Scarring

May be correctable with various treatments, including additional surgery.

Seroma

When clear fluid accumulates in the surgical site. Small seromas may need to be aspirated, or sucked out, once or more by the surgeon.

Vulvoplasty Post-operative care

You will be admitted to the recovery residence two days before your surgery. After your surgery, you will stay in hospital for up to three nights. Then you will return to the recovery residence for about seven days.

You will likely receive painkillers and antibiotics to prevent infection. Your surgeon will provide you with a list of medications to avoid for the first month. Do not resume taking hormones until your surgeon has advised you to do so.

During the healing process, you can expect:

. bleeding from incisions during the first 48 hours following surgery

. itchiness and small shooting electrical sensations as nerve endings heal

. bruising, which can spread from your belly to your thighs and which takes 3 to 4 weeks to settle down

. a bit of spraying when you urinate, which usually improves over time

. swelling of your labia, which can take up to 6 weeks to resolve

. your vulva to approach its final appearance at 4 months

. numbness, which will improve over the first few months, and can take up to 18 months to resolve

. red, dark pink or purple scars, which take up to one year to fade

Vulvoplasty Recovery time

Recovery time varies from person to person, so always follow the advice of your surgeon. Many people begin to feel more comfortable during the second week after their surgery. You'll need plenty of rest in the first two weeks. It's common to be back to your usual activities, including work, in six to eight weeks. Some activities, such as driving, heavy lifting, exercise, sex, and soaking in hot tubs, may be restricted in the post-operative period. Your surgeon will give you advice about when it is okay to resume these activities. Complete recovery can take up to one year.

Vulvoplasty Surgical revision

A surgical revision of a vulvoplasty, if needed, would typically take place 6 to 8 months after your surgery is complete. Common reasons for a surgical revision include:

. To adjust the size, shape, location or hooding of the clitoris

. To adjust the size or shape of the labia minora or majora

Source:

http://www.phsa.ca/transcarebc/surgery/gen-affirming/lower-body-surgeries/vulvoplasty