Narrow neovaginal width in a transgender patient due to short interramic distance

Abstract

Vaginoplasty is one of the core procedures for transgender patients. A neovaginal cavity is created between the prostate and rectum. The width of the introitus is determined by the distance between the inferior pubic rami. A 32-year-old transgender patient underwent vaginoplasty. Surgery was uneventful. When starting the dilation regimen, insertion of the usual stent was impossible since the neovagina had restricted width. A CT scan of the pelvis showed that the interramic distance, at 3.0 cm below the lower border of bony structure of the symphysis pubis, was only 3.2 cm. If a transgender patient presents with short stature, a short interramic distance may be expected. Preoperative radiological imaging should be considered. Surgeons should be equipped with adequate-size stents for postoperative dilation regimen.

Level of Evidence: Level V, risk / prognostic study

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