Robotic Peritoneal Flap vs. Perineal Penile Inversion Techniques for Gender-Affirming Vaginoplasty

Blair R. Peters, Leigh H. Martin, Christi Butler, Daniel Dugi, Geolani W. Dy

Research output: Contribution to journalReview articlepeer-review

1 Scopus citations


Purpose of Review: To discuss perineal and robotic approaches to gender-affirming vaginoplasty. Recent Findings: The Davydov peritoneal vaginoplasty has its origins in neovaginal reconstruction for vaginal agenesis. It has been adapted as a robotic-assisted laparoscopic procedure and provides an alternative to perineal canal dissection in gender-affirming vaginoplasty. Both techniques represent variations of penile inversion vaginoplasty with successful outcomes and overall low rates of major complications reported in the literature. However, there are differing advantages and considerations to each approach. Summary: A perineal approach has been the gold standard to gender-affirming vaginoplasty for many decades. Robotic peritoneal gender-affirming vaginoplasty (RPGAV) is an emerging alternative, with potential advantages including less reliance on extragenital skin grafts in individuals with minimal genital tissue, especially among patients presenting with pubertal suppression, and safer dissection in revision vaginoplasty for stenosis of the proximal neovaginal canal. Additional risks of RPGAV include those associated with robotic abdominal surgeries.

Original languageEnglish (US)
Pages (from-to)211-218
Number of pages8
JournalCurrent urology reports
Issue number10
StatePublished - Oct 2022


  • Gender-affirming surgery
  • Penile inversion vaginoplasty
  • Robotic surgery
  • Transgender
  • Vaginoplasty

ASJC Scopus subject areas

  • Urology


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