Sexual Function After Shallow and Full-Depth Vaginoplasty: Challenges, Clinical Findings, and Treatment Strategies— Urologic Perspectives

This article presents an ordered review of the role of sexual function in discussion and planning before genital gender-affirming surgery and through recovery to initiation of sexual activity after surgery. Strategies are proposed to optimize sexual function postoperatively. Clinical observations are reviewed and genital and surgical anatomy is reviewed to explain the rationale for the treatment strategies proposed. The importance of offering shallow-depth vaginoplasty to all patients is discussed. Lastly, specific strategies to maximize and enhance recovery of erogenous sensation after surgery are focused on.