Intestinal vaginoplasty in transgender women

Penile inversion vaginoplasty is the surgical gold standard for genital gender-affirming surgery in transgender women. When there is shortage of penile skin, because of previous circumcision, use of puberty blockers, biological variation, genital (self-)mutilation or when previous vaginoplasty has failed, a pedicled intestinal segment may be used as neovaginal lining. In this article, our surgical technique is presented, as well as surgical and patient-reported outcomes. Generally, postoperative outcomes are reported to be good. Surgical alternatives comprise full- or partial-thickness skin graft vaginoplasty, pedicled flap vaginoplasty, or peritoneal vaginoplasty.