Vaginoplasty

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Vaginoplasty is any surgical procedure whose purpose is correction of vaginal structural defects or to construct or reconstruct the vagina. When vaginoplasty is performed to produce a new vagina when one is lacking, it is sometimes called neovaginoplasty. However, surgeons whose practices consist primarily of performing vaginoplasty procedures to construct new vaginas rarely, if ever, use that term.

There are several non-reconstructive vaginoplasties, such as vagina tightening and toning, particularly in women (or their sexual partners) who have experienced orgasmic difficulties due to the loss of muscle tone, such as in disease or after giving birth by vaginal parturition.

Various surgical techniques exist for creating a neovagina. The Vecchietti procedure is a laparoscopic procedure that has been shown to result in a vagina that is comparable to a normal vagina in patients with Mullerian agenesis.^[1][2]. Most vaginoplasty procedures performed at present, for creation of new vaginas, are performed on transsexual women. The penile inversion techniques were evolved by the Biber and Granato ^{[citations needed]} (need ref. to Journal Urology articles from pubmed) during the 1960s through the 1980s.

In the 1990s and continuing to the present, neovaginal construction has been futher advanced by Toby R. Meltzer, M.D., whose technique involves the use of both penile and scrotal tissue to form the vaginal vault, and has yielded more reliable sexual sensation, maintenance of vaginal depth, and a stronger pelvic floor by maintaining a nearly intact levitor ani muscle complex. ^[3] Meltzer creates a neurologically sensate clitoris, constructed from a penile glans pedicle, with its attached blood supply and nerves. During a secondary procedure using Meltzer's technique, he forms a labia hood for the clitoris using the inverted Y plasty suturing method, leaving only a single midline incision scar.^{[4] [5]} The term vaginoplasty has also been applied to surgical procedures that relieve an imperforate hymen or restore a ruptured hymen.

[edit] See also

• Intersexuality.
• Sex reassignment surgery male-to-female.
• Hymenorrhaphy.
• Hymenotomy.

[edit] References

1. ^ Vecchietti G.Creation of an artificial vagina in Rokitansky-Kuster-Hauser syndrome. Attual Ostet Ginecol 1965;11:131-47
2. ^ Fedele L, Bianchi S, Tozzi L, Borruto F, Vignali M, A new laparoscopic procedure for creation of a neovagina in Mayer-Rokitansky-Kuster-Hauser syndrome. Fertil Steril 1996;66:854-7
3. ^ Anne Lawrence, MD Vaginoplasty: Dr. Meltzer Multipage photographic surgical presentation Note Surgical Photos
4. ^ Anne Lawrence, MD Labiaplasty: Dr. Meltzer Performs Labiaplasty - Multipage photographic surgical presentation Note Surgical Photos
5. ^ Toby R. Meltzer, MD Aesthetic Refinements to the Secondary Labiaplasty - XVII Harry Benjamin International Gender Dysphoria Association Symposium (abstract)