Male-to-Female Gender Affirmation Vaginoplasty via Laparoscopic Pedicled Peritoneal Flap-An Initial Experience

Objective  The objective of this study was to describe our early experience with laparoscopic pedicled peritoneal flap in patients undergoing male-to-female gender affirmation vaginoplasty. Methods  This is a case series of five patients who underwent laparoscopic pedicled peritoneal flap vaginoplasty for gender reaffirmation from October 2020 to July 2021. The clinical and functional outcomes were recorded. Results  Two patients underwent the surgery as a primary procedure, and three patients underwent surgery as a secondary deepening procedure after failed penile skin inversion. There were no complications after surgery, and the median length of hospital stay was 3 days. No patient developed vaginal stenosis in 6-month follow-up period, and the median vaginal depth was 6 inches with a healthy vaginal surface. Conclusion  Laparoscopic pedicled peritoneal flap can be considered as a first choice in gender affirmation surgeries for patients with inadequate penoscrotal skin or failed penile skin inversion.