Phallus-preserving vaginoplasty is a surgical procedure performed as part of gender-affirming care. Sometimes referred to as penile preserving vaginoplasty or Salmacian surgery, this type of vaginoplasty creates a neovagina while preserving the existing penis. It’s often an important consideration for individuals who wish to maintain the option of using their penis for sexual function or other reasons.
During this procedure, the surgeon creates a neovagina using penile and scrotal tissues while retaining the penis. The procedure involves reshaping and repurposing these tissues to form the vaginal canal. The goal is to provide individuals with a functional and aesthetically pleasing vagina while maintaining the original genital structure.
Specific techniques and procedures are determined by the individual's preferences, goals, and medical considerations. Non-binary and transgender individuals often work closely with their healthcare team to determine the most suitable approach for their gender affirmation journey.
Phallus-preserving vaginoplasty is a gender-affirming procedure. It is chosen based on personal preferences, goals, and medical reasons. This surgical approach caters to a range of individuals. Some individuals want to affirm their gender identity without undergoing a standard penectomy. Individuals may choose to retain their penis for sexual function or personal identity. Alternatively, they may opt for retention. This surgery offers gender affirmation while preserving the existing genital structure.
Some individuals are drawn to this unique approach. It can allow them to maintain certain aspects of their original anatomy. Those wanting sexual function post-surgery may find this option aligns with their goals. The reasons for choosing phallus-preserving vaginoplasty vary, encompassing factors like sexual function, fertility preservation, urinary function, and individual identity.
Individuals who are considering phallus-preserving vaginoplasty should engage in thorough discussions with qualified healthcare professionals. Talk to surgeons and mental health specialists about your unique circumstances. It will help you choose the most suitable path for your gender affirmation journey.
During phallus-preserving vaginoplasty, the surgeon typically uses the penile skin and tissue to construct the neovagina. The procedure involves inversion of the penile skin to form the vaginal canal. The testicular tissue is often used to create the labia minora. The glans of the penis may also be used to create a clitoral hood, simulating the appearance of the clitoral area. If there isn't enough skin available between the penis and scrotum to create the desired depth of the vaginal canal, a skin graft sourced from the hip, lower abdomen, or inner thigh may be used.
Preparing for phallus-preserving vaginoplasty involves a combination of medical, logistical, and emotional considerations. First, schedule consultations with experienced gender-affirming surgeons who specialize in phallus-preserving vaginoplasty. Discuss your goals, expectations, and any concerns you may have. This will help you make an informed decision about the procedure. Having a good understanding of what to expect can help alleviate anxiety. This can also contribute to a smoother recovery.
Your gender-affirming care team will recommend undergoing physical and mental health evaluations with qualified professionals prior to the procedure. A comprehensive medical evaluation will assess your overall health and identify any potential risks or contraindications for surgery. Conversations with a mental health professional can help ensure emotional readiness for the surgery and any additional recommendations related to gender dysphoria and gender affirmation.
If you are undergoing hormone therapy, discuss the prescribed regimen with your doctor and surgeon. Hormone therapy may be part of the preparation process for some individuals.
It's also recommended to maintain a healthy lifestyle. This includes regular exercise to promote overall fitness, quitting smoking and limiting alcohol consumption. Follow any preoperative instructions provided by your surgeon. Following guidelines on diet, medications, and hygiene is essential.
Lastly, make logistical arrangements for the surgery, including travel plans, accommodations, and support during the recovery period. Establish a strong support system of friends, family, or a support group who can provide emotional support and assistance during the recovery process.
The recovery process after phallus-preserving vaginoplasty is a crucial period that requires careful attention to postoperative care. While individual experiences may vary, there are some general expectations during the recovery phase.
You will likely spend a day or two in the hospital after the surgery for initial monitoring and postoperative care. Pain and discomfort are common initially. Your healthcare team will provide pain management medications as needed. A urinary catheter may be in place temporarily to assist with urination during the initial recovery period. Swelling and bruising around the surgical site are normal and should gradually subside over time.
Upon release from the hospital, there will be at-home care to carefully manage. Proper wound care is crucial. You should clean and care for the surgical site as instructed by your healthcare team. Most patients are also restricted from doing certain activities during the initial weeks after surgery. This may include strenuous exercise, heavy lifting, and sexual activity. Gradually, you will be able to resume normal daily activities. The timing for the resumption of specific activities will be guided by your surgeon's recommendations.
Beyond physical care, emotional support is equally important during recovery. It is essential to have a family member or friend available 24/7 for support especially during the first couple weeks after surgery. It's common to experience a range of emotions both in the pre and post-operative period. Having a support system in place is crucial.
Regular follow-up appointments with your surgeon will be scheduled to monitor your healing progress and address any concerns. During these appointments, you might also receive hormone therapy adjustments and scar management instructions.
It's important to follow the postoperative care instructions provided by your healthcare team closely. Each individual's recovery experience is unique, so be sure to communicate openly with your healthcare providers about any concerns or questions you may have during the recovery process.