Feminizing Genitoplasty

Girls who have a disorder of sex development (DSD) sometimes have genitals that do not look or function normally.  Feminizing genitoplasty (jen-i-toe-plas-tee) is a surgery or group of surgeries to improve both the look and function of the genital area.  

Before deciding if surgery is the best option, you will need to meet with the DSD team.  The team may include:

  • Endocrinologist
  • Geneticist
  • Gynecologist
  • Psychologist
  • Urologist 

This group of specialists will go over the benefits and risks of the surgery and will discuss the best time to have surgery. Families are involved in this talk and take part in deciding when their child will have surgery. 

Girls with a DSD can have a large clitoris, fusion of the labia (where the labia are joined together), or no labia or vagina.  They may have a single opening for the vagina and urethra.  To correct these conditions, surgery may involve one or more of the following steps:

  • Clitoroplasty reduces the size of an enlarged clitoris, while saving feeling to the area.
  • Vaginoplasty creates a vagina with enough depth and length for future intercourse.
  • Labiaplasty creates the inner and outer labia and/or frees adhesions.

Before scheduling surgery, the DSD team will examine the patient and get any X-rays, scans or tests that are needed. 

To decrease the risk of infection, it is important to clean out the bowel before surgery. The patient will drink a salty liquid that will cause repeated bowel movements.  This will help clean out the bowel. This is done at home or in the hospital the day before surgery.

You will also meet the pain management team when you come to the hospital. They will talk to you about choices to help reduce the amount of pain after surgery.  Surgery is done while patients are asleep and they will not feel any pain during that time. 

After surgery, you may stay in the hospital for two days or more.  Sometimes, patients go home with a small, soft tube that helps drain urine from the bladder – this tube is called a Foley catheter.  It may need to stay in place for several days.  You will need to schedule a visit with the surgeon to have the tube removed and to have a follow-up exam.

You may get several medicines to take at home, including:

  • An antibiotic to prevent infection
  • Pain medicine
  • Medicine to stop bladder spasms while the catheter is in place   

You will learn about these medicines and how to care for the surgery site before you go home. 

After surgery, call the doctor if you have any of the following issues:

  • Pain or bladder spasms even though you are taking the medicine
  • Fever of 101° or higher during the week after surgery
  • Vomited more than three times and can’t keep liquids down
  • The Foley catheter falls out or is not draining urine
  • Problems with the surgery site, such as:
    • The surgery site has opened
    • Drainage from the suture lines
    • Increased redness, swelling and pain 

You should also call us with any other concerns you may have.

Last Updated 02/2014