Many FTM’s will undergo removal of the ovaries, tubes and uterus including cervix. A subtotal hysterectomy means the cervix has not been removed and really should before one can proceed to colpocleisis.
Colpocleisis involves the removal of vaginal epithelium and subsequent imbrication (sewing together) of the vaginal muscularis (wall). The vagina is not removed, but the intent of this procedure is to close the cavity, which is helpful to reduce complications from urethral extension following metoidioplasty, namely fistula formation. The lining of the vagina or mucosa is cauterized ultimately leaving a raw granular surface which is approximated internally with a helically applied suture placed in a purse string like manner. .A drain is left within for several days to avoid fluid collections. The raw internal surface being approximated adheres together obliterating the cavity. Complications can include bleeding, infection and conceivably injury to adjacent structures although in my experience this has not happened. Colpocleisis should be considered an irreversible procedure in that a normal vaginal cavity may never again be regenerated.
Harold M. Reed, M.D. FICS
Senior Member of the American Urological Association
Member Society of Genito-Urinary Reconstructive Surgeons
Founding Member and Treasurer of American Academy of Phalloplasty Surgeons
Founding Member Sexual Society of North America