PURPOSE OF REVIEW: This review summarizes the most recent advances in the field of vaginoplasty. New surgical techniques and recent modifications to existing techniques are included as well as up-to-date outcome data when available. RECENT FINDINGS: It is increasingly clear that vaginal dilation treatment is a successful method of vaginal creation and avoids the risks of surgery. When vaginal dilation is unsuitable or unsuccessful, however, vaginal reconstruction surgery is needed. Most of the novel advances in vaginal reconstruction have been related to the advances made in laparoscopic techniques. It is anticipated that as surgeons become more adept at such procedures, maximally invasive procedures such as intestinal neovagina may be necessary only in a small minority of patients. Autologous vaginal tissue transplantation may also transform this field. Long-term sexual function outcome data are essential for full evaluation and comparison of surgical techniques and the recent literature has begun to include this information. SUMMARY: Vaginal dilation treatment should be the first choice of treatment. If unsuccessful, laparoscopic techniques offer good outcomes and quick recovery. Additional research into the long-term outcomes of sexual satisfaction, orgasm and patient body image is essential, however, to allow a comparison of newer and traditional procedures.
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