Secondary Colon Vaginoplasty for Treating Vaginal Narrowing or Stenosis
By Dr. Chettasak Tulayaphanich | WIH International Hospital
When Is Revision Surgery Needed?
At WIH International Hospital, secondary colon vaginoplasty is a highly effective revision procedure for transgender women who have undergone gender-affirming surgery but are now experiencing complications such as:
- Vaginal narrowing or stenosis
- Vaginal canal blockage or closure
- Inadequate depth or functional limitations
Understanding Vaginal Canal Contraction
Vaginal canal contraction refers to the progressive loss of vaginal depth and/or width due to scar tissue formation. It is a known complication in both cisgender and transgender women, but is particularly relevant for neovaginas constructed from skin.
Dr. Chettasak uses a 4-grade system to assess the severity of canal shortening:
- Grade 1: Original depth reduced to ~5 inches
- Grade 2: Further reduced to ~4 inches
- Grade 3: Reduced to ~3 inches, often with narrowing
- Grade 4: Less than 3 inches, non-functional canal
Important: Once depth is lost, it cannot be regained through dilation alone — and attempting to do so may worsen the scarring.
When Is Surgery Required?
- Mild cases (Grade 1–2): May be managed non-surgically with consistent dilation.
- Severe cases (Grade 3–4): Require surgical intervention to restore function, appearance, and comfort.
The revision procedure involves excising scar tissue and reconstructing a new canal using one of the following techniques:
- Skin graft vaginoplasty
- Peritoneal vaginoplasty
- Colon vaginoplasty (most recommended)
Why Colon Vaginoplasty Is Ideal for Revision
Dr. Chettasak recommends colon vaginoplasty as the most effective method for severe vaginal contraction and other complex complications such as vaginal fistulas.
Key Advantages of Using Colon Tissue:
- Own Blood Supply – Enhances survival even in scarred areas
- Durability – Withstands friction and resists shrinkage
- Lubrication – Natural mucus production prevents dryness
- Depth – Consistently provides 6–7 inches of functional canal
These benefits make colon tissue the gold standard for secondary vaginoplasty.
Surgical Expertise at WIH International Hospital
With over 20 years of experience, Dr. Chettasak Tulayaphanich leads one of the most advanced teams in the world for laparoscopic colon vaginoplasty. Our multidisciplinary approach ensures safe outcomes and personalized care for every patient.
If you are experiencing vaginal narrowing or complications after your initial vaginoplasty, contact WIH Hospital to explore a reliable solution with long-term success.
