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Genital or Sex Reassignment surgery is the surgical modification of existing genitals to better match the appropriate sex of a person.
A Vaginoplasty is a surgical procedure that is intended to construct a vaginal canal and its mucous membrane. Vaginoplasty is a general term that describes any similar vaginal surgery, often also including a labiaplasty, with the term neovaginoplasty describing the procedure of either partial or total construction of the vagina. The most common forms for MtF are described here.
In this procedure, the skin of the penis and part of the scrotal skin is used to create the internal vagina, other scrotal skin is used to create the labia and part of the glans is used to create a clitoris. The internal vaginal skin is formed around a stent and inserted into the created vaginal vault. During this procedure, the urethra is also realigned, with the target site being as natural as possible. Depending on the amount of donor tissue available, this procedure may also require skin grafts be taken from other sites in order to provide enough tissue for a sufficient vaginal canal.
This is much the same as a Penile Inversion, but uses a section of the sigmoid colon to provide additional tissue aiding in the creation if the vaginal canal.
A phalloplasty is a surgical procedure intended to create a penis. There are several different methods, but the key steps are mostly the same and are what will be described here. Firstly, a graft is removed from elsewhere in the body - often the forearm, leg or the side of the chest. This graft is then 'rolled' and sutured to create the neophallus. Additional suturing and shaping is also done to create the glans. The phallus is then attached, it is also connected to a blood supply and nerve tissue is also often connected at this point. As the neophallus contains no erectile tissue an implantable erectile prostheses is often used to enable an erection.
This procedure is intended to release and reposition the clitoral tissue to a more forward position, so it more closely resembles the location of the penis. Due to the effects of testosterone, the clitoral tissue will grow and because of this, results of up to 10 cm have been reported. Most also report a result that is erectile and sensate. The urethra is also often extended during this procedure, allowing the neophallus to be used for urinating. A scrotoplasty is often also done at this time. Vaginectomy, hysterectomy and/or oophorectomy can also be done at this time, if any of it has not previously been done.
A scorotplasty is the surgical creation of a scrotum. This is often done by releasing the skin of the labia and using them to form a scrotal pocket. Prosthetic testes can then be introduced.