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Information on colon cut vaginoplasty (Sigmoid colon vaginoplasty, colon graft vaginoplasty, colon transplant vaginoplasty)

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Sigmoid colon or colon cut vaginoplasty is a procedure, in which a section of the rectosigmoid colon is used to transplanted into vaginal tunnel and can provide the excellent depth (between 7 and 8 inches).

Since the vascularized colon segment can carry a good blood supply and heal on scar tissue (for example on scar tissue inside the recreated vaginal tunnel for those whose vaginal depth is short or even collapse after their first SRS operation), so it is ideal for revisional vaginoplasty (secondary colon vaginoplasty) to restore funtional vaginal depth.

In my opinion, the colon vaginoplasty should not be considerred as primary colon vaginoplasty because this procedure is more intrusive than standard sex reassignment surgery with skin graft as the abdominal cavity is entered.

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Surgical technique

  • Patients are placed in lithotomy position. A simultaneous abdominal and perineal approach is performed by two teams.

  • A Pfannenstiel incision (low transverse abdominal incision) is used for entering the abdominal cavity.

  • A 18-20 cm.of the colon segment is selected for transplantation on its rectal vascular pedicle as a modifying method described by R.C Franz (M.D.), whereby transection of the mesenteric vessels provides immediate mobility for the colon segment to reach the perineum.

  • The mobility provided at this step is excellent. The distal colon opening can be easily slided down through the previous constructed tunnel for suturing to the vaginal opening by the plastic surgeon.

  • The proximal end of the colon segment is closed with running of non-absorbable sutures. The abdomen is closed without drainage.

  • The distal opening of the colon segment is sutured to the vaginal opening skin. The Z-plasty and perineal skin V flap are used to decrease the effect of circular scar contracture at the mucous-skin junction.

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    Preoperative preparation and assessment

  • Bowel tract contrast media study (x-ray barium enema) is needed before surgical scheduling.

  • At the first inspection, your external genitalia, existing vaginal depth and condition of scarring inside will be evaluated carefully.

  • You need to admit into the hospital 1 day for bowel cleansing preparation prior to the surgery.

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    Recovery after colon procedure

  • You can ususally take liquid diet or soft diet within 2 or 3 days after your bowel starts to move.

  • The vaginal packing and urinary catheter are removed after 3 days.

  • Early ambulation helps speed up the recovery function of your bowel and also reduces the risk of deep vein thrombosis (blood clot in vessels).

  • Some mucous discharge may come out from the vaginal as this is a natural secretion from the inside colon mucosa.

    • Possible complications

  • The risk of wound infection increases at the abdominal incision and/or genital area

  • Intrabdominal fluid collection or infection or inflamatory adhesion (intra-abdominal scar) which may cause bowel tract obstruction

  • Vaginal opening narrowing is due to circular scar contracture at the muco-perineal junction.

  • Abundant mucous discharge from neovagina.

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    Result 3 months after colon vaginoplasty
    移植直肠重建阴道手术
    Vaginal dilatation with 8 inch (20cm.)depth after colon surgery
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