There is a lot of talk about Peritoneal Pull Through vaginoplasty as an option for gender-affirming surgery for trans women.

• Potential of self-lubricating?

• More vaginal depth?

• Requires less dilation?

• Less Douching?

• Less risk of prolapse?

Most importantly, who offers this procedure, and does it work?

Known in gynecology as a Davydov Procedure, the use of the peritoneum in vaginoplasty was first described in Russian literature. The procedure was designed to help patients with congenital absence of the vaginal canal, known as MRKH syndrome.

Peritoneal Pull Through vaginoplasty is a new development in gender-affirming surgery for trans women.

In gender-diverse patients, the peritoneum (an abundant, moist inner lining of the abdominal wall) is pulled down into the potential space between the rectum and the urethra/prostate to serve as the future vaginal lining (MoZaicCare.net.)

Till now, the Peritoneal Pull Through procedure has been known to be used only for patients who need salvage vaginal reconstruction. Patients whose only option is colon procedure or patients who need more grafting than is available by the commonly used penile inversion technique.

Today, prominent doctors in gender-affirming surgery, such as Dr. Heidi Wittenberg, offer this procedure. And not only to a few individuals who do not qualify for more common penile inversion!

That’s right! Dr. Wittenberg offers Peritoneal Pull Through vaginoplasty to patients desiring this method. This has been personally confirmed by me calling their clinic!

POTENTIAL BENEFITS

• Self-lubricating lining with some elasticity.

• Less need for douching.

• Less prep hair removal.

• More vaginal depth.

• Lower risk than colonic vaginoplasty.

It is important to remember that the Peritoneal Pull Through technique, while commonly practiced in gynecology on cis-gendered women, is a new method for gender-diverse patients. As such, there is a substantial lack of long-term clinical data in regard to long-term outcomes.

POTENTIAL RISKS

• All the risks of penile inversion vaginoplasty.

• Additional risks of an abdominal laparoscopic procedure, including intra-abdominal organ injury, ileus, herniation, and others.

• Flap failure and stenosis.

• Unknown long-term outcomes.

As with any serious surgery, it is important to be an informed consumer. Have a full discussion with your doctor about the risks and benefits involved. Be mindful of any lack of available research, data, and clinical outcomes.

For those considering this method, I encourage reading the recent post Peritoneal Pull Through Vaginoplasty Procedure, by Dr. Wittenberg. As well as watching her discussing this procedure on Mosaic Care YouTube.

Other potential doctors offering this procedure:

• Dr. Rachel Bluebond-Langner

• Dr. Jess Ting

While this surgery is at the forefront of science, it is worth considering if you plan to undergo vaginoplasty.

If you are looking for a skilled surgeon, make sure to screen them. And if you need help on how to do that, read 11 Tips on How to Choose a Gender Affirming Surgeon!

You may also find the following helpful:

• 2 Big Reasons Why Transition is Not a Magic Pill!

• Your Gender is Not an Apology! 3 Steps Toward Self Acceptance.

• 2 Main Reasons Why Surgical Transition Alone Won't Make You Happy!

• Are You Questioning if You Should Transition?

WATCH EXPERT VIDEOS ON GENDER DYSPHORIA

REFERENCES & SOURCES

http://www.trans-health.com/2019/peritoneal-pull-through-vaginoplasty-procedure/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4229793/

https://lookaside.fbsbx.com/file/PeritoneumVaginoplasty.pdf?token=AWzcq8pCrE8-ZBQOas16boYMc-HCarkAGKXgoUFlhFvwGHqqtvbkbLtS3EVk4qgwPxhiU1TvOdGiKD35V-LmCiVdyl49lmKEY9q_u8FedexqAMwGw2cYEGGctcz_oftrhVGohnt2M6SCVDAMsrE9gFZDaow04x2ogrWRdjFOC_xvfA