Colovaginoplasty Genital reconstruction

That’s a surgical technique whose objective is to achieve adequate depth using a colon segment to cover the neovagina.

Genital Reconstruction Surgeries

The surgeon, together with his medical team, will decide the most appropriate technique for each individual patient, analyzing their physical and social characteristics. However, the patient will have all the information to be able to take part in the final decision on the technique to choose.


What’s the colovaginoplasty?

The colovaginoplasty consists of making a deep vaginal cavity, using a segment of the colon, specifically the sigmoid colon, that is, the large bowell that is just before the rectum, to make the vaginal cavity. The colon segment is pediculized, that means that the vessels that regularly irrigate it, are used to take it to the area where the neovagina will be located. The rest of the large bowel that has been cut, joins the rectum. In this way we will achieve a vaginal depth as long as we want, a great lubrication due to the mucous secretion that the colon has and the possibility of having completely normal and pleasant sexual intercourses.

One of the differences with the simple vaginoplasty is the depth, with a colovaginoplasty we can reach 20 cm or more. Usually we leave a segment of the large bowel that goes from the vaginal introitus to the upper part of the sacral promontory, that is, to the abdominal cavity, hence the sexual intercourses become completely normal. Another difference is that the colon mucosa secretes mucus, so it lubricates very well the neovagina. The reason why this technique is not performed in all patients is because it’s a longer surgery with a longer recovery time. Moreover a surgical connection in the large bowel has healing times and may have life-threatening risks in case of anastomotic leak. There may be intra-abdominal infection or necrosis of the bowel graft that we have interposed between the prostate and the rectum. As a result it is a more delicate surgery and with a little more risk, so it is reserved for people who want to get more depth and who accept the risks.

It is necessary to do a prior evaluation to be able to advise each patient who is the best technique for him, so you always have to talk about your sexual habits, if you want much depth and what partner you have. There are people who do not want to have sex and the depth does not matter too much, only the appearance, people who are homosexual within their transsexuality, so they will never have relationships with a man, people who are older and more at risk and do not want to assume them.




Surgical time

Surgical time

8 hours.

Admission time

Admission time

4/6 days.

Type of anesthesia

Type of anesthesia


Type of surgery

Type of surgery


Recovery time

Recovery time

30 days.

Genital reconstruction


16.000 €

This price includes:

Preoperative tests

Preoperative consultations

Surgical procedure and hospital admission

Follow up

Vaginal dilators kit

Pathological exam

And if necessary in the follow up:

Flexible vaginoscopy evaluation

Blood analysis evaluation

Ultrasound evaluation

We perform a colovaginoplasty mainly when the patient comes to the consultation and requests an important depth. If with a simple vaginoplasty you cannot foresee offering that depth, you should consider practicing a colovaginoplasty. The suspicion of not being able to obtain sufficient depth is based on the length of the skin of the penis before the surgery.

Colovaginoplasty has a little more risk than simple vaginoplasty because in addition to treating the tissues in the perineal area, that is, outside the abdomen, we also have to treat internal organs through the abdominal cavity. Hence, we have to take a segment of the large bowel and restore the continuity of the digestive tract by means of a suture, from the place where we have taken that segment of the large bowel to make the vaginal mucosa. It is precisely these two steps that add risk to the procedure.

To perform a colovaginoplasty, a segment of the large bowel is used to make the vaginal cavity. Like the large bowel, this segment placed in the vaginal cavity secretes mucus of colonic origin and harbors bacteria of colonic origin, so that mucus emissions can occasionally occur through the vulva and sometimes with a bad smell due to germs present in that mucosa. However, the emission of this mucus is beneficial for sexual intercourses since they are completely lubricated and pleasant.

The patient must remain hospitalized a little longer than after a simple vaginoplasty since, in addition to controlling bleeding, possible bruising and the possibility of infection, the intestinal sutures must be controlled, however today, after any colon surgery, a longer admission from 4 to 6 days is not recommended to avoid hospital related complications such as specific infections or venous thrombosis. The same period of admission is advised for a colovaginoplasty.

The most important complication in colovaginoplasty is failure of the colon suture, this means that if you have a colonic anastomotic leak in the postoperative period, intestinal contents are poured into the abdominal cavity. It is a serious complication that requires urgent reoperation and in some cases the preparation of a counterpart anus to solve it (colostomy). However, in centers with experience in digestive surgery such as ours, these complications are detected early, given the experience of our surgeons in this kind of surgery, and are resolved quickly and efficiently, reducing the severity of the complication.

The best results in terms of lubrication and depth since here we are not limited by the length of the penile skin and a colon segment of around 20 cm can be used. that will allow us to obtain the desired depth.

The vaginoscopy or the rectosigmoidoscopy evaluation involves inserting a flexible endoscope through the vaginal cavity and the rectus sigmoidal cavity to assess the condition of the two cavities. This evaluation is very useful in patients in whom the healing has been very slow or in patients in whom we may suspect a communication between the colovaginoplasty and the digestive tract. It is performed with superficial sedation and allows us an exhaustive analysis of the two cavities to assure the patient that the scarring process is progressing favorably.

The best professionals for your peace of mind

The Jesus Lago Institute team is made up of highly experienced and qualified doctors and healthcare personnel and has an Outpatient Surgery Support Center with state-of-the-art equipment for monitoring their patients.
IMPORTANT: The information contained in this web is only for guidance and general purposes. In no case is it intend to replace a personal consultation where your particular case is evaluated and where an accurate diagnosis will be obtained. If you wish, you can request a consultation without any commitment to evaluate your case. We are concerned that the provided information is the correct one for you. If you don't understand any word or explanation, please don't hesitate to contact us.
Last update / January 8, 2024
Clínica Fuensanta
Miembro SECE
Centro autorizado por la Comunidad de Madrid
Miembro SECO
Miembro SEEDO
AE Cirujanos
World Professional Association for Transgender Health
Sociedad Española de Directivos de la Salud
International Federation for the Surgery of Obesity
European College of Aesthetic Medicine & Surgery