Peritoneal Pull-Through Vaginoplasty In Thailand

Peritoneal Pull-Through Vaginoplasty, also known as Peritoneal Vaginoplasty, is a new male-to-female surgery method based on the Davydov Gynecological method.

Peritoneal Pull Through Procedure – Similar to the Davydov Procedure, an abdominal technique is used to collect peritoneum and produce Denonvilliers fascia between the rectum and prostate, allowing for neo-vaginal or vaginal reconstruction. dangers include all of the dangers associated with a penile inversion technique when performed concurrently, as well as stricture, stenosis, graft failure, lack of lubrication, and abdominal procedure-related injury to the intestines, bladder, prostate, muscles, nerves, and arteries. Another issue is a scarcity of literature and long-term evidence on this method.

Peritoneal Vaginoplasty Advantages:

Self-lubricating lining with flexibility

More vaginal depth.

Requires less dilation and douching.

Requires less pre-operative hair removal

Lower risk of prolapse.

It may be less harmful than Sigmoid Colon Vaginoplasty, with no odorous mucus discharge and no need to monitor colon pathology.

Preparation before surgery:

During consultation, the medical history, physical examination, and laboratory tests will be assessed, including allergies, major medical conditions, and all drugs (prescription and non-prescribed).
 Avoid smoking for 3-4 weeks before surgery as it disrupts circulation and hinders healing.
 Avoid alcohol for a week before surgery and during recuperation.
To avoid complications, avoid taking medications including hormones, anticoagulants, anabolic steroids, and vitamins for 4-6 weeks (approximately 1.5 months) before surgery. Avoid taking aspirin, anti-inflammatory medicines, and herbal supplements because they can cause bleeding.

Types of anesthesia include general anesthetic agents.

Hospital admission:

Admission stays in the hospital for 5-7 days.

Surgery typically lasts 6-8 hours.

During this procedure:

During surgery, a laparoscope and various instruments are put into the abdomen through small incisions about 5-8 mm (approximately 0.31 in). These instruments enable dissection of the possible gap between the lower urinary tract (urethra, prostatic urethra, and bladder) and the rectum. This place will be the future vagina. Peritoneum flaps can be pulled through the urethra and rectum to line a section of the vaginal canal. The apex of the vagina is segregated from the abdominal contents by shutting the peritoneal lining around 15 cm (5.91 in) away from the vaginal opening. The remaining vaginoplasty procedures (labiaplasty, clitoroplasty, penectomy, orchiectomy, partial urethrectomy, and other related procedures) are identical to the penile inversion method.

Recovery Period:

The patient remained in bed for a few days. There were no acute problems noted. On the third day after surgery, the condom containing betadine-soaked petrolatum gauze was removed. A vitality assessment on the peritoneal flap demonstrated good color and turgor. The drains and urinary catheter were withdrawn, and voiding was evaluated. Standard wound care was used. Vaginal dilation was conducted immediately using a small-sized acrylic dilator, twice daily, till the next follow-up appointment. The patient was released on postoperative day five.

Risks and complications:

All the hazards associated with penile inversion vaginoplasty.

Additional hazards associated with an abdominal laparoscopic procedure include intraabdominal organ damage, ileus, herniation, and others.

Flap failure and stenosis.

Unknown long-term consequences.