Category Archives: Urethral spongiosum rest

Had vaginoplasty elsewhere, tissue swelling blocks entrance to vagina

Dr. Reed, May need a vaginoplasty revision.  Although I can dilate with the smaller stents fairly easily, when aroused I get swelling especially on the left side of the vagina and my boyfriend has trouble entering.  What can you do to fix this?  Is this fairly easy to correct?  Gabriella

Dear Gabriella,

More likely than not, you have a remnant of urethral tissue called a urethral spongiosum rest.  A rest is an anatomic term relating to a known tissue type which is in an incorrect location.  Normally the urethra swells in men when aroused, as it is surrounded by erectile tissue.  During transgender vaginoplasty, the surgeon will try to suture over and/or coagulate this tissue to reduce its potential for swelling.

The approach we use is trans-vaginal.  The urethra is catheterized. A longitudinal incision is made under the urethra.  The catheter is palpated and as much of the spongy tissue on either side is ligated with suture as deeply in as possible. Then opened distally and coagulated.  The trans-vaginal incision is then closed.  If the urethral opening is too high (voiding up, instead of down), we can fix this at the same time.  Similarly we can provide more pink for your vulva.  A non-specific but generalized term would be urethroplasty.

Hoping this is of help,

Harold M. Reed, M.D.
The Reed Centre for Transgender Surgery | Miami


Urethroplasty after male to female vaginoplasty

Hi, Do Dr.Reed work with United Healthcare Medical Insurance for reconstructive surgery for a URETHROPLAST, I had my SRS already.My insurance said they will cover my surgery depending Dr.states reconstruction surgery & using the right codes. There is an area on the left that swells and causes my stream to be directed up and to…Continue Reading

Seeking vaginoplasty revision, stream does not go down and urethral bulge

Hi,Dr.Reed, Need a vaginoplasty revision.  I had my SRS in August 2014,in Thailand .Why,I need the surgery.I always have had a problem voiding,it doesn’t go towards the water,it would either go forward hit the space between seat and bowl,getting my undies wet or hit the bowl, which then splash back at me.My Mon pubs &…Continue Reading

Long work list and disappointment following vaginoplasty

Dear Dr. Reed, Had a vaginoplasty elsewhere about 7 months ago and post-op had a hematoma on the left side.  The skin over it, became frail and sloughed off.  At this time I do not have a clitoris, nor is that area erogenous.  Can induce orgasm after 20 to 25 minutes working much lower. The…Continue Reading

Urethral spongiosum rest

Dr. Reed,  I had a vaginoplasty about 8 year ago and have a lot of swelling just above my vagina when I am aroused.  It makes penetration very difficult.  I think this is too low for my clitoris. Daniella Dear Daniella, More likely than not, you have a urethral spongiosum rest.  There are 3 erectile…Continue Reading

Had Sex Change Vaginoplasty, now Swelling just above my vagina

Dr. Reed, Had a sex change (MTF) vaginoplasty abroad and when my boyfriend touches me down below, I get a bulge just above my vagina.  At times, makes penetration a little difficult. Any idea what’s going on. Andrea Dear Andrea, This sounds like a classical urethral spongiosum rest to me.  The word “rest” is a…Continue Reading

Urethral Spongiosum Rest, post Vaginoplasty, feel bulge when aroused

Dr. Reed   Had sex change vaginoplasty 2 years ago and feel a midline bulge just above my vagina when I’m aroused which makes penetration difficult.  It’s below my clitoris. Katrina Dear Katrina, Based upon what you are saying, seems as though you have a urethral spongiosum rest or some erectile tissue left over that normally…Continue Reading

Revision of vaginoplasty, Labiaplasty

Dear Dr. Reed,  Please consider my request for revision of vaginoplasty which was done elsewhere here in the USA.  My stream does not go down and I have a bulge when I am aroused which makes penetration somewhat awkward. Wendy Dear Wendy, Thank you for visiting our web-sites and also We have seen just…Continue Reading

Post GRS with Urethral spongiosum rest and need labiaplasty as well.

Good day! I’m a post op TS girl from Ireland, my GRS was 6 years ago and I’m a little disappointed of the outer appearance of the vagina. Would like to get some information and pictures + experiences from patients. My main concern is that the area around the urethra gets hard and a little…Continue Reading