Sigmoid colon vaginoplasty, also known as sigmoid colon vaginoplasty with rectosigmoid graft, is a surgical technique used for vaginoplasty, which is a gender-affirming surgery for male-to-female (MTF) transgender individuals. It involves using a section of the sigmoid colon (a part of the large intestine) to create the neovagina (new vagina).

During sigmoid colon vaginoplasty, the surgeon creates an incision in the lower abdomen and accesses the sigmoid colon. They detach a segment of the sigmoid colon while preserving its blood supply. The segment is then carefully prepared, reshaped, and lined with the colonic mucosa (inner lining of the colon).
The next step involves creating the vaginal cavity in the pelvic area. The surgeon makes an incision between the rectum and the bladder, creating a space for the neovagina. The reshaped sigmoid colon segment is then inserted into this space, serving as the neovaginal canal. The blood supply to the graft is carefully reconnected to ensure adequate blood flow.

Once the neovaginal canal is created, the surgeon sutures the surrounding tissues to form the vaginal opening and provide support. A dressing or packing may be placed in the neovagina to aid in healing. Over time, the colonic mucosa lining the neovagina gradually transforms into a tissue that resembles vaginal epithelium.

Sigmoid colon vaginoplasty is a complex surgical procedure that typically requires an experienced surgeon specializing in transgender surgeries. As with any surgery, there are risks and potential complications associated with sigmoid colon vaginoplasty, such as infection, bleeding, urinary complications, fistula formation, strictures, and potential changes in bowel habits. It is important to have a thorough discussion with a qualified surgeon to understand the benefits, risks, and expected outcomes of the procedure, as well as to ensure you are a suitable candidate for this surgical technique.