Peritoneal Pull Through Surgery

The following links are to photos of patients who have had Peritoneal Pull Through Procedures (PPT) with Dr. Wittenberg and Dr Bonnington. Patients' anatomy differ, as does their healing abilities. Therefore, it is important to understand that these photos are representations of each individual's results and not indicative of what a prospective patient will receive. However, patients with similar medical histories, anatomy, and healing abilities may expect similar results.


Peritoneal flaps do not have extensive or longterm results available.


People interested in this procedure tend to have colon lining as their sole option for vaginal lining. They have already had a penile inversion technique but have lost depth and need a salvage procedure; they have been on blockers, have had trauma, or were born with inadequate amount of skin for skin grafting techniques; or are gender diverse and desire to keep their penis, as well as, having a vagina.

Primary Vaginoplasty Option:

We are now offering this technique for patients who would like a primary vaginoplasty with the additional peritoneal flap for the vaginal lining. Our technique fully lines the vaginal canal. This is not the hybrid technique that uses penile shaft skin, possible scrotal skin for lining and then adding peritoneal lining as a cap. 

Since we usually have the additional penile shaft skin available, we are using this skin for labia minora folds. If it is not available, then we use sutures to try and create labia minora definition like our penile inversion vaginoplasty technique.

Benefits to date of full length peritoneal lining of the vaginal canal include some minimal lubrication and no future hair growth in the vagina.

As pelvic surgeons, we are the primary surgeons from start to finish of this case and do not require additional multi-specialty surgeons to perform parts of this procedure.