Table 70-12 Comparison of inverted penile skin flap (and variants) and mesocolonic neovaginal construction procedures

Penile skin techniques
Technically easier to perform
7,000-15,000 U.S. dollars
Recovery time: days
Many skilled surgeons worldwide
Complications include fistulae, strictures, loss of vaginal depth, urinary stream problems, intravaginal dryness
Need for frequent dilation or intercourse to prevent loss of vaginal depth
Graft donor site(s) scarring
Depth limited by host donor penile tissue dimensions
Maintains orgasmic capacity in majority
Over three decades of experience worldwide
Mesocolonic techniques
Major intra-abdominal surgery
20,000+U.S. dollars
Recovery time: at least 1 week
Fewer skilled surgeons

Complications include excess neovaginal fluid, postoperative problems
with colonic end-to-end anastomosis, friability of neovaginal walls,
introitus stricture
Dilation less important
Depth not limited by host donor tissue
Maintains orgasmic capacity in majority
Newer procedure with less longitudinal experience