Vaginoplasty is to create neovagina. In transgender male to female vaginoplasty, penile skin inversion, skin graft, skin flap and colonic flap were used. Peritoneal vaginoplasty has been used for the reconstruction of vaginas in females born with congenital vaginal agenesis (eg, Mayer-Rokitansky-Küster-Hauser [MRKH] syndrome). Traditionally, the eponymic “Davydov” procedure uses a sliding peritoneal flap pull-down into the vaginal cavity. Recently, a series of laparoscopic vaginoplasty techniques using a single peritoneal flap in MRKH syndrome patients has been reported. The advantages of using the peritoneum for vaginal reconstruction include its abundant availability, proximity to the vagina, mucosal-type surface, and selflubrication.
In male-to-female (MtF) gender affirmation surgery, penile skin inversion (PSI) vaginoplasty remains the standard surgical technique. Intestinal vaginoplasty or nongenital grafting is often used for secondary deepening procedures. Some authors reported successful use of the Davydov procedure for augmenting neovaginal length in a postsurgical transgender woman (TGW). Peritoneal vaginoplasty has become an exciting procedure for TGW who are unable to undergo (or have failed) PSI. Although the pedicled peritoneal flap can achieve a deeper neovaginal cavity than the original pull-through procedure, there are no reports of its use in primary vaginoplasty in TGW. We present the case of a transgender woman with penoscrotal hypoplasia who underwent primary peritoneal vaginoplasty for her gender incongruence.
