![]() ![]() It is unlikely that you will be able to go through pregnancy by yourself if your uterus is tiny or absent. It is very likely that you will be able to become pregnant if your uterus, ovaries and fallopian tubes are normal. Your anatomy will be the biggest factor in whether you will be able to have children. Since the changes are internal, no one will be able to tell that you have had treatment. Since much of sexual pleasure comes from stimulation of the clitoris (the female erectile structure), and not the vagina, you should enjoy normal sensations and a good sex life. Lubrication after bowel vaginoplasty is less of a problem. Lubrication will likely be needed since the skin will not make the same substances as normal vaginal tissue. Though you should talk to your health care provider before having sex, it is often ok to start 4 to 6 weeks after treatment. Patients have many questions about life after treatment. If this occurs, dilation will be performed while you are under anesthesia. You will be seen 3 weeks after surgery and again in 3 months. Only 1 operation is needed with bowel vaginoplasty. Vaginal stenosis, or a tightening of the vagina, is the major drawback of this method. After 3 months, you mostly wear the dilator only at night for about 6 months. It is removed for voiding, bowel movements, showering and sex. Patients treated with a skin graft most often wear a vaginal dilator for 3 months after surgery. A catheter is placed in the bladder through the urethra so that urine can drain. After the surgery, a mold is placed in the new vagina for 3 days. The colon is sewn onto the vaginal remnant, acting as a vaginal opening. One end of the bowel is then closed while the other stays open. During surgery, part of the lower colon is removed through a cut in the belly. The night before surgery, you must empty your bowels to remove stool and bacteria. A catheter is placed into the bladder so urine can drain. After surgery, you are likely on bed rest for a week. The surgeon then makes a small cut where a vagina would normally be, between the rectum and the urethra, and places the mold so the graft will attach to make the inside of a vagina. Artificial skin has also recently been recommended. The surgeon takes a thin piece of skin from the patient’s buttocks and places it over a mold to make a vagina. The vagina can be made with a graft of skin or buccal mucosa (inner lining of the cheek), or with part of the large bowel. Most young women will need surgery, and how this is done can vary. This works best for girls who have a dimple in the area. ![]() This is easier after a bath because the skin is soft and stretches well. A very small tube, called a dilator, is pressed against the skin where the vagina should be for about 15 to 20 minutes a day. Some young women can have a vagina made without having surgery. Most girls start treatment in their teens, but some may want to wait until they are ready to become sexually active. But when she starts this process is up to her. Many ask at what point a girl should think about having a vagina created. ![]()
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