Neovaginal Cavity Dissection in Gender Affirmation Surgery for Trans Female: Assisted Endoscopic Light Guide Method

Background: One of the most challenging and critical procedures for gender affirmation surgery in trans female is neovaginal cavity dissection due to its variation in the pelvic cavity. Patients and methods: To describe the method of neovaginal dissection in male-to-female gender confirmation surgery using an assisted light guide method, and surgical landmarks. Results: A total of 116 patients aged 19-72 years (mean, 28.9) underwent neovaginoplasty using this technique between January 2018 and December 2019. Patients without a light guide method were excluded from the study. Intraoperative rectal injury and postoperative rectovaginal fistula were not found after one year of follow-up. Conclusions: The use of an assisted light guide method minimizes the rate of rectal injury. The plane of dissection anterior to the prostaticovesicular fascia is the key to success.