Penile-peritoneal vaginoplasty (PPV) and Sigmoid colon vaginoplasty are two surgical procedures used to construct a neovagina for transgender women or individuals with congenital vaginal anomalies. PPV uses a segment of the patient's own peritoneum, which is the lining of the abdominal cavity, to construct the neovagina. The peritoneal flap is tunnelled from the abdomen to the pelvis to create the neovagina. The peritoneum is a mucosa membrane that is similar to vaginal tissue and is self-lubricating, wet and elastic.
On the other hand, Sigmoid colon vaginoplasty uses a segment of the patient's sigmoid colon, which is a part of the large intestine, to construct the neovagina. The sigmoid colon is tunnelled from the pelvis to the perineum to create the neovagina. The sigmoid colon is also wet, self-lubricating and elastic. Both procedures have their own advantages and disadvantages, and the choice of which to use depends on factors such as the patient's anatomy and the surgeon's experience and preference.
A negative aspect of PPV is that it is new and has no long-term results in transgender women, however, it has been used successfully for over 45 years in cisgender women known as the Davydov technique using the peritoneum to make vaginal canals is not new and has been used on cis girls born without a vaginal canal for decades. It is important to note that the initial year of dilation is crucial in PPV, and it is not suitable for people with a short penis, previous abdominal surgery or fatty abdomens.
Sigmoid colon offers the deepest vaginal canal at 7 inches (16-19 cm). Contrary to rumour, Sigmoid colon vaginoplasty does not have an odour. The recovery is slower for sigmoid colon as the diet is extremely limited after surgery for a few weeks as the digestive system heals and returns to normal function. Sigmoid colon is considered more invasive than PPV but has post op advantages of depth and long term result data.
Both PPV and SIgmoid colon each have their advantages and disadvantages and deciding which to choose is a personal choice depending on the individual needs of each individual patient.
Both procedures require multiple stages,and carefull preoperative evaluation of the patient as well as post-operative care to ensure the best possible outcome.