Vagina is the elastic and muscular part of the female genital tract, extending from urethra to the cervix. It goes without saying that vagina is the most important sex organ in females and the most characteristic too. It also goes without saying that the women intending to change their identity and sexuality by transitioning to men would prefer to get rid of the most characteristic and typical female sex organ, the vagina.

Vaginectomy is the process of removal of vagina.

It can be of two types: partial and radical.

It is radical (the whole vagina) is removed and partial (only upper part of the organ is removed). Usually, it is performed together with total abdominal hysterectomy.

HOW VAGINECTOMY IS DONE

• The procedure is performed under general anaesthesia. The patient is placed in a position resembling the position in which a woman gives birth to expose the vaginal and perineum area.
• The surgeon then examines the whole pelvic area and inserts a catheter to the bladder. A long incision is made around the vagina, and the cut is deepened down into the pelvic floor to the pubocervical fascia.
• The surgeon then separates the mucosa from the lateral wall of the vagina. The pudendal artery is identified, clamped, and then tied off. The dissection of the vagina is done under the urethra and bladder, taking care not to injure the innumerable blood vessels in that region.
• Another surgeon may then perform total hysterectomy by making a large cut in the abdominal region. The peritoneal cavity is accessed to locate the vagina and the bladder. The bladder is dissected from the vaginal wall. The surgeon continues the dissection to detach the vagina from the uterus, the cervix, and the rectum.
• The whole vagina is slowly removed, taking care not to injure nearby parts.

In colpocleisis, the vaginal wall or the muscular lining of the vagina is removed and the muscle flaps surrounding the vagina are stitched together carefully to close it.

Closure or removal of the vagina is compulsorily essential for creation of a new penis. But in metaidioplasty it is optional as in this the reconstruction of penis takes place on the existing genital tissues. They are generally done together because the vaginal wall or lining is used to make the urethral extension.

POSSIBL RISKS AND COMPLICATIONS:

Like any other major surgical procedure vaginectomy is also not free from some health risks such as:

• Uncontrolled bleeding from the operated places or the incisions during and after surgery.
• Infection which could travel to the bloodstream, may affect all other parts of the body leading to a life-threatening condition called sepsis.
• Constant leaking of urine caused by an accidental opening between the urinary bladder and the vagina.
• The rectum may not function properly.