Vaginoplasty Surgery in Hyderabad, India | Cost & Procedure Benefits

Vaginoplasty is a surgical procedure that can be indicated for a variety of reasons, including reconstructive, repair and tightening purposes, feminizing the gender and congenital conditions. There are different types of vaginoplasties depending on the technique used to perform the neovagina, which includes:

• Penile-Inversion Vaginoplasty (MTF vaginoplasty): It is considered the gold standard (best vaginoplasty) for feminizing gender in transgender people (male to female genital reconstruction), which involves inverting the penile skin to create a neovagina. 
• Intestinal Vaginoplasty (Colon vaginoplasty): In this procedure, surgeons create a vaginal canal where they use a segment of the intestine and that is often performed when there is insufficient penile or scrotal tissue. 
• Peritoneal Vaginoplasty: This newer technique also called as intestinal vaginoplasty or peritoneum pull-through vaginoplasty, uses the lining of the abdominal cavity called the peritoneal lining to create the vaginal canal. It is becoming more popular due to its potential for improved lubrication and reduced risk of hair growth inside the neovagina.
• McIndoe Vaginoplasty: It is also called as McIndoe procedure, involves creating a neovagina using a skin graft, typically from the patient’s thigh or buttocks, which is often performed for patients with congenital (inborn) absence of the vagina (e.g., Mayer-Rokitansky-Küster-Hauser syndrome)
• Buccal Mucosa Vaginoplasty: This technique is often performed when other tissues are not available or suitable, where this procedure involves using tissue from the inside of the mouth (buccal mucosa) to create the vaginal lining.
  

Vaginoplasty surgery is often performed for a variety of reasons and is indicated in several conditions, including:

• Postpartum vaginal laxity (sensation of vaginal looseness): Gynaecologists may recommend vaginoplasty in cisgender women to address vaginal laxity resulting from childbirth or natural ageing, to enhance sexual satisfaction and comfort.
• Ambiguous genitalia: In some cases, a baby may be born with ambigu ous genitalia (genitalia isn't clear, either male or female) due to conditions like congenital adrenal hyperplasia (CAH) (an inherited genetic condition), causing the body not to produce the right hormones. Vaginoplasty can be part of a set of surgeries to match the person's gender identity and functional needs.
• Vaginal Hypoplasia or Agenesis (like those with CAIS or MRKH): Some people are born with a condition where the vagina doesn’t develop properly or is completely missing in certain conditions such as complete androgen insensitivity syndrome (CAIS) & Mayer-Rokitansky-Küster-Hauser Syndrome (MRKH), where the vaginoplasty is performed as a single procedure to create a functional vagina from other materials or tissues.
• Gender dysphoria: Vaginoplasty is performed on transgender women who feel uncomfortable or dissatisfied with their biological sex and gender identity. It is often part of their gender affirmation process, helping align their physical appearance with their gender identity.
• Aesthetic reasons: Some women seek vaginoplasty for cosmetic reasons (cosmetic vaginoplasty), wanting to improve the appearance of the vagina. This may be driven by personal preferences or self-esteem considerations.
• Sexual Function: Vaginoplasty may be considered to improve sexual health and satisfaction for women with significant sexual function issues or vaginal pain due to structural abnormalities.
• Genital Trauma or injury: Injury to the vaginal area from accidents or other physical trauma may necessitate surgical reconstruction.
• Cancer: Vaginoplasty is helpful in cancer patients who may need vaginal reshaping and reconstruction after undergoing radiation to treat cancer. 

Women who have the following conditions are not recommended to undergo vaginoplasty:

• A history of vulvodynia: It is a chronic pain or discomfort in the vulva (outer part of female genitals)
• Dyspareunia: Painful sexual intercourse that can be experienced before, during, or after intercourse caused by a number of medical or psychological factors.
• Bowel and bladder control issues: Difficulty with bowel movements or problems with urinary or anal control 
• Pelvic organ prolapse: Dropping of the muscles and tissues supporting the pelvic organs (rectum, uterus or bladder) into the vagina due to weakness.
• Rectocele: Dropping or bulging of the rectum into the vagina
• Cystocele: Dropping or bulging of the bladder into the vagina
• Chronic pelvic pain: Pain in the pelvic region that lasts for a long term
  

Vaginoplasty procedure primarily reduces the width of the vagina for reasons of function and well-being and the advantages of vaginoplasty include:

• Restore vaginal tightness
• Enhanced sexual satisfaction
• Enhanced aesthetics
• Improved quality of life 
• Improvement in physical function and psychological well-being
  

Before planning vaginoplasty for a specific person, a surgeon takes the following into consideration: 

• History: Surgeons consider the obstetrical and gynaecological history of the patient, including:
• Delivery method: How the woman gave birth 
• Trauma of vaginal child birth: Vaginal childbirth can be physically traumatic, especially if tools like forceps or a vacuum are used.
• Multiparity: Multiple pregnancies
• Macrosomia: Baby is much larger than average, or has excessive birth weight
• Other medical conditions: Evaluation for vaginoplasty and perineoplasty candidates should include assessment for following:
• Urinary incontinence: Whether the patients have urinary continence (urine leaking issues) and other issues related to the pelvic area.
• Pelvic organ prolapse (POP), such as rectocele and cystocele: A cystocele is associated with urinary frequency, urgency, and incontinence; a rectocele is associated with constipation, including a history of digital manipulation to facilitate defecation.
• Vaginal examination: Gynaecologist considers how wide the vagina is and how well the supporting pelvic muscles are working.
• Body mass index: Having a high body mass index (BMI > 30) can raise the risks in any person. However, it is a particular concern in women interested in vaginoplasty and perineoplasty because extra weight puts a lot of strain (pressure) on the pelvic floor, which can lead to problems including pelvic organ prolapse (POP), leakage of urine (urinary incontinence), cystocele (bulging of the bladder into the vagina) and rectocele (bulging of the rectum into the vagina).
• Menopause: A gynaecologist can consider the menopausal woman's overall health, hormone levels, vaginal tissue condition, and potential risks, as well as her psychological readiness and expectations, before planning vaginoplasty.
• Realistic expectations: Managing expectations of patients is essential, especially when considering vaginoplasty for cosmetic reasons. Open communication between the surgeon and patient helps establish realistic goals and outcomes. 
• Risks and benefits: Surgeons assess the risks and benefits of vaginoplasty for each patient to prevent potential complications.

Women considering vaginoplasty should consult with experienced healthcare professionals (gynaecologists or plastic surgeons) to explore their options and make informed decisions based on their unique needs and goals.

Vaginoplasty preparation

Vaginoplasty preparation (before surgery) involves several essential steps to ensure optimal outcomes and minimize complications. This includes:

Quitting smoking: Stoppage of tobacco before surgery is important because it can reduce the risk of potential complications and improve the results of the procedure.

Assessments: Before vaginoplasty, a patient may have certain tests to evaluate hormone levels, especially in menopausal women, detect infections, and assess anatomical structures and overall health.

Hormonal preparation: Postmenopausal patients considering vaginoplasty will be recommended to be on oestrogen to thicken their vaginal tissues before surgery.

Specific preoperative requirements: For individuals assigned male at birth (AMAB) undergoing vaginoplasty for gender affirmation, specific preoperative requirements, such as genital hair removal, are reviewed with the healthcare expert.

Anaesthesia: Vaginoplasty is performed using either general anaesthesia (the patient sleeps completely) or a pudendal block (numbing of the lower part of the body).