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Objectives: To describe a technique for gender affirmation vaginoplasty using purely a combination of penile and scrotal skin flaps as lining of the vaginal canal.
To show that there is adequate scrotal skin that can be used as a flap, to complement the penile skin flap to completely line the neovaginal canal without the need of skin grafts.

Introduction: Gender affirmation vaginoplasty is a surgical procedure that involves creating a neovagina in transgender women. The most common technique is the penile inversion vaginoplasty wherein the penile skin is used to line the vaginal canal. However, in many cases where there is not enough penile skin, it needs to be complemented with scrotal skin flaps and scrotal skin grafts to completely line the whole neovaginal canal. The technique described in particular shows how penile and scrotal skin flaps are fashioned as lining of the neovagina that minimizes the need for skin grafts.

Materials / method: In this lecture, the technique described in particular shows how a combination of penile and scrotal skin flaps are fashioned as lining of the neovagina that minimizes the need for skin grafts. We will discuss how this technique with the use of a short obturator, will be able to efficiently make use of the peno-scrotal skin flaps to line the neovaginal canal.

Results: The technique described has been able to completely line the neovaginal canal with the use of the penile and scrotal skin flaps. With the use of a short obturator, this technique was able to fashion the penile and scrotal skin flaps adequately and efficiently without having to add skin grafts to line the canal of the neovagina.

Conclusion: The peno-scrotal skin flap vaginoplasty technique described using purely penile and scrotal skin flaps as lining of the vaginal canal is an effective technique in gender affirmation vaginoplasty that minimizes the need for skin grafts. There is adequate scrotal skin flap to completely line the neovaginal canal.

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