Limitations of Peritoneal vaginoplasty (PPV)

Limitations of PPV

       Peritoneal vaginoplasty (PPV) is a surgical procedure used to create a functional and aesthetically pleasing vagina in individuals born with male anatomy, typically transgender women. However, the procedure does have several limitations, including:

  1. Limited depth of the vagina: The depth of the vagina created using peritoneal vaginoplasty may be limited to around 6 inches - 14 cm which may be a concern for those who desire a deeper and more spacious vagina, or who wish to engage in sexual intercourse with a partner with a larger-than-average penis.

  2. Not suitable for very overweight people: Due to the presence of visceral fat, which is internal fat that covers the peritoneal, the surgery may be difficult or impossible to perform in individuals who are very overweight.

  3. Limited long-term data in transgender people: There is a lack of long-term data on the safety and effectiveness of PPV in transgender individuals. Therefore, it is important to consider this when deciding to undergo the procedure.

  4. Initial dilation can be painful: The initial dilation process in the first weeks post-surgery can be uncomfortable or even painful. It is important for patients to be prepared for this and work with their surgeon to manage any pain or discomfort.

  5. Not suitable for people with very small penis: Due to the need for sufficient skin to connect to the peritoneum, individuals with very small penis may not be good candidates for PPV.

  6. Previous abdominal surgery: Previous abdominal surgery can damage the peritoneal making it unusable for vaginoplasty. Therefore it is important to inform the surgeon about the history of previous abdominal surgery.

  7. Risk of complications: As with any surgical procedure, PPV carries a risk of complications such as infection, bleeding, and wound healing problems. These risks should be thoroughly discussed with a surgeon before making a decision to undergo the procedure.

PPV is not considered a high risk surgery.