Vaginoplasty

Vaginoplasty is any surgical procedure that results in the construction or reconstruction of the vagina. It is a type of genitoplasty. Pelvic organ prolapse is often treated with one or more surgeries to repair the vagina. Sometimes a vaginoplasty is needed following the treatment or removal of malignant growths or abscesses to restore a normal vaginal structure and function. Surgery to the vagina is done to correct congenital defects to the vagina, urethra and rectum. It may correct protrusion of the urinary bladder into the vagina (cystocele) and protrusion of the rectum (rectocele) into the vagina. Often, a vaginoplasty is performed to repair the vagina and its attached structures due to trauma or injury.

Congenital disorders such as adrenal hyperplasia can affect the structure and function of the vagina and sometimes the vagina is absent; these can be reconstructed or formed, using a vaginoplasty. Other candidates for the surgery include babies born with a microphallus, people with Müllerian agenesis resulting in vaginal hypoplasia, trans women, and women who have had a vaginectomy after malignancy or trauma.

Vaginoplasty is the description of the following surgical interventions:

In some instances, extra tissue is needed to reconstruct or construct the vagina. These grafts used in vaginoplasty can be an allotransplantation, a heterograft, or an autologous material. A woman can use an autologous in vitro cultured tissue taken from her vaginal vestibule as transplanted tissue to form the lining of the reconstructed vagina. A reconstructed or newly constructed vagina is called a neovagina.

Conditions such as congenital adrenal hyperplasia virilize genetic females due to a 21-hydroxylase deficiency. Specific procedures include: clitoral reduction, labiaplasty, normalizing appearance, vagina creation, initiating vaginal dilation. Vaginal atresia, or congenital absence of the vagina, can be another reason for surgery to construct a normal and functional vagina. Vaginoplasty is used as part of the series of surgeries needed to treat those girls and women born with the bladder located outside of their abdomen. After the repairs, women have been able to give birth but are at risk of prolapse.

There are human rights concerns about vaginoplasties and other genital surgeries in children who are not old enough to consent, including concern with post-surgical sexual function, and assumptions of cisnormativity. There is no consensus attitude among clinicians about their necessity, timing, method or evaluation. Vaginoplasties may be performed in children or adolescents with intersex conditions or disorders of sex development.

Non-surgical vagina creation was used in the past to treat the congenital absence of a vagina. The procedure involved the wearing of a saddle-like device and the use of increasing-diameter vaginal dilators. The procedure took several months and was sometimes painful. It was not effective in every instance. Uncommon growths, cysts, septums in the vagina can also require vaginoplasty.

Radiological cancer treatment can result in the destruction or alteration of vaginal tissues. Vaginoplasty is often performed to reconstruct the vagina and other genital structures. In some cases, normal sexual function can be restored.