Zero Depth Vaginoplasty (Feminizing Vulvoplasty)

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Gender Services Program

Zero depth vaginoplasty is a reconstructive procedure for transwomen that includes orchiectomy, penectomy and creation of a sensate neoclitoris, labia minora and major without creation of a neovagina.


This is a one-staged procedure that feminizes the external genitalia without the added recovery and need for dilation. In contrast to the full-depth vaginoplasty, patients do not need to have permanent hair removal performed or a bowel prep before surgery.


Patients who have a history of prostate issues or radiation or do not desire penetrative intercourse may choose the zero depth option. This procedure is performed under general anesthesia and is followed by a two- to three-day inpatient hospital stay while the urinary catheter is in place.


Frequently Asked Questions


Who is a good candidate for zero depth vaginoplasty surgery?


The UW Health team follows the World Professional Association for Transgender Health (WPATH) standards of care and requires that patients are 18 years of age and have two letters of readiness for surgery by mental health providers. Patients must be on hormonal therapy and live in an identity-congruent gender role for at least one year.


Gender affirming surgery has been shown to have lasting benefit in mental and physical functioning in transwomen who desire reconstructive surgery. Patients with prior history of orchiectomy are candidates for zero depth vaginoplasty surgery.


What should I do in the time leading up to my zero depth vaginoplasty surgery?


Your doctor will give you instructions before your surgery, including guidelines on eating, drinking and taking or avoiding certain medications and vitamins. Avoid smoking or tobacco use four to six weeks before surgery and aspirin 14 days before and after your procedure.


Permanent hair removal with laser or electrolysis is not required for a zero depth procedure.


Hormonal therapy (estrogens) must be stopped three weeks prior to surgery to prevent blood clots. Hormonal therapy will be restarted one to two weeks after surgery.


What should I expect following a zero depth vaginoplasty procedure?


Immediately following zero depth vaginoplasty surgery, you may experience temporary soreness, swelling, bruising, sickness upon waking from anesthesia and changes in sensation. You will have a temporary urinary catheter in place for two to three days. You will remain in the hospital with modified activity restrictions during that time. You will have one surgical drain in place will which removed following discharge from the hospital. Recovery time (time off work and strenuous activities) following a zero depth vaginoplasty is 3-4 weeks total, shorter than a full depth vaginoplasty.