Transsexualism - Male to Female Surgery Using Rectosigmoid Colon

Male to female surgery using the rectosigmoid colon is appropriate surgery for patients with less than average penis length or those with a circumcised penis. This surgery, used by our Team, and in the past from Prof. Sava Perovicis, is performed through a combined trans-abdominal and trans-perineal approach. All parts of the external female genitalia are created at the same moment. The clitoris is created by reducing the glans like to the penile inversion technique. The new labia minora is made from the inner preputial layer and of the outer layer. The vagina is created from a part of the rectosigmoid colon (bowel) which is isolated and moved into the previously created pelvic space. Vaginas created this way have natural lubrication as well as excellent sensitivity.   




Rectosigmoid Vaginoplasty

















• Division of rectal segment from its mesentery can be done due to its good intramural vascularization

• Bowel segment should be placed in peristaltic position to allow better mucous discharge


• It is optimal to create wide tunnel passable for 2-3 fingers

• Vaginal tag or various flaps (suburethral and/or perineal) should be used in order to achieve deep perineal and avoid circular anastomosis


Vaginal absence – Mayer-Rokitansky syndrome


















Isolated short segment of rectosigmoid.

Colo-rectal anastomosis using stapling device














Wide tunnel for neovaginal placement passable for 2-3 fingers



















Deep perineal anastomosis is created using vaginal tags.

Fig.1 - Outcome one-year after surgery.
Fig.2 - Outcome one-year after surgery


Related Arguments:

  • Transgender
  • Sava Perovic technique
  • Vaginoplasty




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