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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.


The peritoneal pull through vaginoplasty procedure was initially used for people who otherwise only had colon lining as an option for vaginal lining. This includes those who have already had a penile inversion technique but have lost depth and need a salvage procedure; those who have been on blockers, have had trauma, or were born with an inadequate amount of skin for a skin grafting techniques; or those who are gender diverse and desire to keep their penis and also have a vagina.

Primary Vaginoplasty Option:

We are now offering this technique for patients who would like a primary vaginoplasty with a peritoneal flap for the vaginal lining. Our technique fully lines the vaginal canal with peritoneum. This is different from the hybrid technique that is offered at some clinics, which uses penile shaft skin and/or scrotal skin for lining the first 1/3 - 2/3 of the vaginal canal and then adding peritoneal lining for only the deepest portion of the vagina.

For primary peritoneal pull through vaginoplasty, we usually have additional penile shaft skin available for creating labia minora folds. If it is not available, then we use sutures to try and create labia minora definition, similar to our penile inversion vaginoplasty technique.

Benefits to date of full length peritoneal lining of the vaginal canal include some minimal lubrication and no potential for 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.

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