Potential complications of vaginoplasty
Any surgery carries certain risks. This page discusses some of the risks and
complications associated with vaginoplasty. It probably will not dissuade you
from seeking surgery, but it's important to know some of the problems that may
I am not a physician and this information is not to be
construed as medical advice. All of the information below would be verified
with a trained medical professional, preferably the surgeon who will perform
Death: You could die. Some of the complications below are potentially
Fistula: This is when a hole develops in the wall between the colon
and the vagina. Read a patient report about her fistula.
Blood loss: Some patients have had massive hemorrhaging after vaginoplasty,
requiring many units of blood (up to 15 in one patient's case). There is an
additional small risk that donor blood could carry an infectious disease.
Steps to avoid this: stop all drugs that affect clotting at the time recommended
by your surgeon. Some surgeons recommend banking your own blood prior to surgery.
Blood clots: These can lead to heart attack, stroke. Steps to avoid
this: stop all drugs and hormones at the time recommended by the surgeon.
Infection: This can result from the surgical procedure or from improper
postoperative care. This could affect your recovery time, your surgical outcome,
and in extreme cases could possibly kill you. Steps to avoid this: be very
diligent out hygiene postoperatively, especially regarding bowel movements
Pneumonia: Fluid in the lungs is sometimes contracted after surgery.
Steps to avoid this: Stop smoking. Get in shape. Use an incentive respirator
after surgery or do breathing exercises. Walk or at least sit up as much as
possible after surgery.
Necrosis: Death of tissue. This can be caused by infection, tissue
rejection, or loss of blood supply to tissue.
Vaginal collapse: In severe cases of stenosis, the entire new vagina
can cave in, which may lead to reconstruction and in severe cases removal.
Paralysis: Caused by stroke from a blood clot, or a severed nerve.
Allergic reaction: Severe allergic reactions can cause your air passage
to close or send you into shock. Reactions can be from anesthesia, certain
drugs such as penicillin. Non-fatal reactions include rashes and hives.
Bowel problems: You could have permanent problems, especially if you
have a fistula or get vaginoplasty involving a bowel segment (sigmoid vaginoplasty).
Urinary problems: You could have permanent urinary problems, from
urine stream direction and spraying to problems with incontinence or painful
urination. Your urethra can be very wide, which may cause problems in intimate
situations, or it may stick out or have unremoved spongy penile tissue around
it, which can cause irritation when sitting or walking.
Inorgasmic: You may never have an orgasm again. Ever.
- Depth problems: You may end up with a vagina too shallow for
standard sexual function.
- Stenosis (width problems): You may have a vagina too narrow or
standard sexual function
- Lubrication: You will probably need some sort of lubrication
for any penetrative sexual activity. Some people achieve moderate amounts
of prostatic lubrication, but usually must supplement it. Conversely,
those who have sigmoid vaginoplasty sometimes secrete so much mucus from
the bowel segment in their vagina that they must wear maxi pads at all
- Numbness: You may have numbness in some or all parts of your
genitals, which limits your pleasure and increases the chance of injury
from your lack of sensation during vigorous activity.
- Pain: You may have permanent pain in some areas from a severed
- Hypersensitivity: You may find some areas too sensitive to be
touched. Hypersensitive areas can also cause discomfort from just walking
Scarring: some people have noticeable scarring that is
discolored or raised.
Graft: some patients require a skin graft, which can mean
Keloids: some (notably African-American patients) get
this unusual type of raised red scars
Hair: some patients have reported hair growth inside the
vagina and around the opening. This is difficult to remove after vaginoplasty,
and is the reason many advise getting electrolysis prior to vaginoplasty.
Clitoris size: some women have had clitoris that is much
larger than a typical female's. Others have had one that is too small.
Shape: asymmetrical outcomes are not uncommon, especially
in one-stage procedures.
Labia: sometimes labia are different shapes or positioned
Urethra: some have a urine stream that points in an unusual
direction. Others have had a urethra opening that was big enough that partner
mistook it for her vaginal opening.
Positioning: some have reported the entire vulva is too
thigh or too low, or that there is too much or too little space between
the clitoris and the vaginal opening.
Yeast infection/douching: some have temporary, and in
some cases, chronic problems with yeast infections or unpleasant smell following
Fatigue: Vaginoplasty takes a lot out of you, and many
find that they tire easily in the months following surgery.
Depression: many find that completion of vaginoplasty
leaves them feeling a bit lost, especially if they had expectations that
vaginoplasty would make a major difference in their day-to-day existence.
Regret (didn't put in proper thought): In rare cases,
patients have decided that vaginoplasty wasn't the solution to their unhappiness.
Others detransition after vaginoplasty, because all they wanted was the
surgery and had no success in living as females.
Evacuation: many have problems going to the bathroom for
a while after surgery, from constipation and hemorrhoids, to inability to
control their bladder, sometimes requiring incontinence pads. This usually
resolves itself in a few months.
Mild bleeding: Many have mild bleeding, especially around
sutures or after dilation, which requires the use of a sanitary pad for
a few months.
Bed sores: those who do not move around enough sometimes
get bed sores, which can take a while to heal.
Ripped suture: occasionally someone might tear a suture
from certain types of movement. While usually not a serious problem, it
can cause a small scar.
Clitoral scab: many report they have a scab over their
clitoris following surgery. In some cases, when this falls off,m there is
very little protruding clitoral tissue remaining. This can be corrected
during labiaplasty if desired.
Shocks: many report a sensation of electrical "shocks"
as nerves in the surgical site regenerate. This is especially common in
the legs near the pelvis.
Bruising: You can expect bruising ranging from mild to
significant, which can take many weeks to resolve.
Nausea: following anesthesia, many get nauseated. This
can also be caused by the antibiotics, or the hospital food! ;
Allergic reaction (drugs, leg things, etc): some patients
get contact dermatitis from the leg compression stockings, the catheter,
or from other vaginoplasty related items.