Colovaginoplasty / Colon Section Surgery
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Introduction
A colovaginoplasty, also known as colon section, is an operation where a vagina
is created by cutting away a section of the sigmoid
(descending) or ascending
colon and using it to form a vaginal lining 1.
This surgery has been performed on females with Androgen
Insensitivity Syndrome (AIS) where non-invasive forms of lengthening the
vagina cannot be done although there appears to be little evidence that genital
surgery on children/infants is successful 2.
More often this procedure is performed on adult male-to-female transsexuals
as an alternative to penile
inversion (NB. penile inversions are often performed with an accompanying
skin graft for greater depth with the donor skin taken from either the thigh
or abdomen).
Due to numerous potential complications most surgeons will only recommend a
colovaginoplasty when there is no alternative.
Headings on this page:
Advantages
- Because the colon section is a mucous membrane, as are normal vaginal linings,
a colon-lined vagina feels basically the same as a normal vagina to a partner.
- The colon section provides a constant source of lubrication, reducing the
need for additional lubrication during sex, although some additional lubrication
may make for more comfortable sex.
- With colovaginoplasties it is easy to ensure adequate vaginal depth.
- A colon section is thicker than the skin of an amputated penis or skin graft,
and therefore a patient is far less likely to suffer from a recto-vaginal
fistula
(communication between vagina and anus) than if a penile inversion is performed,
especially if augmented by a skin graft.
- The thickness of the colon section means that a patient is less likely to
incur damage during vigorous sex than with penile inversion.
- There is no need for a skin graft addition to improve vaginal depth as is
often required when a penile inversion is performed, so the patient is spared
the associated pain or scarring caused by the grafts.
- Having a colovaginoplasty can save a M2F transsexual from requiring expensive,
tedious and painful genital
electrolysis prior to surgery.
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Disadvantages
- The surgery is more invasive than alternatives and an additional scar on
the abdomen results from the removal of the colon section. This can be minimised
if you have a skilled surgeon performing this procedure using keyhole
surgery. Some surgeons create a lateral scar which resembles that which
occurs after caesarian childbirth.
- In the case of females with Androgen Insensitivity Syndrome (AIS) if any
vaginal opening is present at all, it is preferable to increase depth via
dilation
than surgery, if possible.
- Colovaginoplasties cost more than penile inversions for M2F transsexuals.
- Patients must be "Nil by Mouth" for approx 8 days after surgery.
- There can be post-operative complications if the colon "shuts down",
and if left unchecked results in extremely unpleasant short-term side effects
of painful abdominal swelling, extreme nausea and regular vomiting. If this
occurs, a nasal-gastric tube (NG tube) should be inserted and regular evacuations
(aspirations) be performed until the colon normalises (generally 2-3 days).
- The colon's constant lubricating action has some unpleasant results:
- In theory, the colon is self-cleaning, passing out secretions and tissue
& blood residue. In practice, this does not always happen and a foul-smelling
faecal-like buildup can occur requiring regular douches (eg. every 1 to
2 weeks or so).
- Often, after douching, not all of the residue is cleaned out, resulting
in temporary "vaginal incontinence" (usually for 1 - 3 hours),
during which time the person will need to use heavy pads (incontinence
pads can be used too) and it's wise to stay at home to avoid embarrassment.
Often this sudden flow is preceded by slight nausea.
- The constant lubrication means that the vaginal area is always wet,
greatly increasing the chance of candida
and accompanying urinary
tract infections. Regular changes of underwear (more than once daily)
and/or use of panty liners is needed to ensure the vaginal area is kept
clean and as dry as possible. Note that the sigmoid, or descending, colon
produces more lubrication than the ascending colon.
- The mucous produced by the colon section is of a thicker consistency
(ie. "gluggy") than that of a natural vagina.
- Unless the surgery is performed skillfully, a colovaginoplasty vagina can
appear obviously constructed, as though the vaginal entrace has prolapsed,
with the bright pink end of the colon section clearly visible and contrasting
to the rest of the vagina (as per pictures).
- The diameter of a penis you are able to accommodate post-op varies according
to your bone structure and your surgeon's skill. The colon is thicker than
penile skin (in the case of choosing a penile inversion). This means that
if you have a bone structure that only allows for a narrow vagina, having
a colovaginoplasty will make you narrower still. There is also a strong risk
of shrinkage at the anastomosis
between colonic and genital tissue, which may lead to stenosis
of the vagina 3
- You can experience chronic pain / neuromas
at the junction where the colon section is sewn to the body and prevent you
from enjoying sex. One common problem for such patients is painful spasm of
the grafted piece of colon during or after intercourse. In some cases surgery
to remove the neuromas may alleviate the problem. In regard to spasms, which
can also occur: "Some success has been reported using loperamide
in such cases, although very often the problem seems to persist". 4
Pictures (Warning: these pictures are graphic and not viewed by minors
or those who are squeamish)
- 3
days post op - close up, showing catheter and bruising
- 7
days post op - front view, showing bruising, abdominal scar and residual
abdominal swelling
- 3
years post op - close up, showing clear visibility of colon section
- Post
op (offsite link) - includes information on the surgical technique.
Links / References
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· Adult Content: This page includes graphic information and
pictures regarding colovaginoplasties and should not be viewed by those under
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· Medical Disclaimer: I made this site to provide information
which may assist those having undergone or considering this surgery. It is not
meant to be a substitute for professional medical advice. This website cannot
take any responsibility for any actions or decisions you make resulting from
accessing the material provided here.
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