These photos were taken about 12 weeks after
surgery. The most remarkable aspect of Dr. Bowers’ technique is her extensive
use of externalized urethral mucosa: In this example, she has extended urethral
mucosa well above the clitoris, not just up to it (as do, for example, Drs.
Brassard and Menard). The patient did not like the appearance of so much pink
mucosa above the clitoris; she hoped that this could be revised, and more
hooding achieved, during a secondary procedure.
The labial structures are small, but there is
plenty of redundant skin around the vaginal introitus that could be used for
labial construction during a secondary procedure. Based on results like this and
comments on her web site, it appears that Dr. Bowers now expects that most of her
patients will undergo a secondary procedure and she has modified her technique
accordingly. The patient reported that her vaginal depth is 5-3/4 in. (14.5 cm)
using a 1-1/2 in. (38 mm) dilator. Erogenous sensation was good, but she had not
yet had an orgasm.
This close-up view, with the tissue surrounding
the urethral meatus pulled downward and laterally, shows the extensive margin of
urethral mucosa that has been preserved around the meatus. I speculate that this
may represent an effort to minimize urethral stenosis, which reportedly was a
problem with a few of Dr. Bowers’ early vaginoplasties. The patient reported a
satisfactory urinary stream.
© 2011 by Anne A. Lawrence, M.D., Ph.D. All rights reserved.