Vulvoplasty

Who is this treatment suitable for?

Trans women and non-binary patients looking for gender affirmation surgery where aesthetic external genitalia is created but not a functioning vaginal tube.

Before any surgery can be carried out patients will have to have followed a care pathway through their local GIC (Gender Identity Clinic) involving hormone treatment and psychological assessment. Some patients will also go through the private sector which shortens their journey. Rather than going through an NHS GIC they will use a private specialist in gender therapy, of which there are several and your surgeon can discuss with you further.

What does the treatment involve?

A Vulvoplasty creates all the parts of female genitalia except for the vaginal canal. In choosing this procedure you will not be able to have penetrative sex.

The procedure is carried out under general anaesthetic and takes approximately 2 to 3 hours.

During a vulvoplasty, your Consultant will carry out the following:

• Create a clitoris out of the glans of the penis with its nerve and blood supply intact
• The erectile tissue of penis is largely removed as are the testicles (this is completely irreversible).
• The urethra is shortened and placed in the normal position so that you can urinate.
• The labia minora and majora are made from penile and scrotal tissue.
• Create a small dip in the tissue where the vaginal tube would have been placed.

This procedure creates the same look as a full vaginoplasty, however you cannot have vaginal penetration as there is no vaginal tube.

Choosing this procedure means you do not have to dilate or douche for the rest of your life.

How should I prepare for the surgery?

• You will need to have a BMI of 30. The surgeon will assess each person’s weight on an individual basis.
• You should be as fit as you can
• Stop smoking 8 weeks prior, including vaping and recreational drugs
• You will need to stop taking hormones 6 weeks before the date of you operation
• Some patients may need to undergo hair removal treatment prior to surgery. However this is rarely required in a vulvoplasty and the consultant will advise at your initial consultation.

Please note all the information on how to prepare for surgery, what happens on each day of your stay, the possible complications and contraindications to surgery will be given to you in a pack by the clinical nurse specialist at your initial consultation with the surgeon.

How long is the recovery process?

Your Consultant will go through your recovery in detail during your consultation and you will also receive lots of information. You will be fully informed of your aftercare when you come for your consultation with the surgeon and your specialist nurse. Patients will be given a list to prepare for discharge, including a robust plan for recovery.

Patients can expect to be in hospital for 5 days on bed rest until day 3. You will be housebound for around 2 weeks post op so it’s important to ensure you have sufficient support arranged for this time. You will be seen around 8 – 12 weeks for a postoperative follow up.

Patients are given a sick certificate for 10 – 12 weeks from operation date. You can start back on feminising hormones 3 weeks from op date. General advice is no driving for 4-6 weeks post-surgery and we recommend that you should check with your insurance company when they are happy for you to resume driving.

Specific risks and complications of this treatment

As with all surgeries there are risks involved with being under general anaesthetic. All patients are fully assessed for their safety prior to surgery.

All possible complications and contraindications to surgery will be discussed with you at your initial consultation with your Consultant. Any questions or worries that you may have will be talked through at this consultation and discussed on a one to one basis and with empathy.