What is Secondary procedures?
Patients who have undergone male to female reassignment surgery sometimes experience problems or complications which might require medical treatment. This can happen after many years, due to mechanical stressing or atrophy of the tissues. It can also be associated with complications or imperfections of the original procedure. In these cases, a surgical revision might help overcome functional or aesthetical problems.
Performance
Depending on the problem, different treatment strategies can be suggested. Revisional surgery of the vaginal pouch is very demanding and has a high risk of intestinal injury and should be avoided, unless totally necessary. If the problem is stenosis of the neovagina, conservative treatment with dilatations should be the initial treatment. If not successful, surgical reconstruction with flaps or skin grafts can be considered. In case of severe stenosis of the vagina, reconstruction with colon may be the only option.
Vaginal wall atrophy means thinning of the inverted penile skin, loss of elasticity and mechanical integrity. This can lead to pain or lacerations during intercourse, bleeding, loss of depth or width and other types of discomfort. Treatment can be minimally invasive, using PRP, stem cells, fat grafting, although in some cases a more aggressive approach is needed.