Restoring Feminine Identity: A Robotic Neovaginoplasty Success Story By Dr. Rubina

Androgen insensitivity syndrome (AIS) is a rare condition where individuals with XY chromosomes develop female external genitalia due to the body's inability to respond to androgens. Managing such cases requires a multi-disciplinary approach to ensure physical, hormonal, and psychological well-being.

A Unique Case of Primary Amenorrhea

A 23-year-old phenotypic female presented to our clinic with desire for neovagina creation for coital reasons . Diagnosed at the age of five with male pseudo hermaphroditism due to AIS, she had undergone bilateral orchidectomy to prevent complications associated with undescended testes. Since adolescence, hormonal therapy had supported the development of secondary sexual characteristics.

Clinical Evaluation and Findings

Upon examination, she exhibited: 

• Well-developed breasts (Tanner stage 4) but 
• underdeveloped pubic and axillary hair 
• Well-formed labia with a blind vaginal dimple measuring 1.5 cm just below the urethra
• Imaging confirmed the absence of additional organ anomalies

Surgical Innovation: Robotic Neovaginoplasty

Given her desire for vaginal reconstruction, she underwent a robotic neovaginoplasty using an ileal loop—a highly vascular segment of bowel that closely mimics natural vaginal mucosa. This technique provides a durable and functional neovagina while preserving bowel integrity and natural lubrication. 

Postoperative Care and Recovery

Following surgery, she was transitioned onto soft solid diet within 48 hours . She recovered uneventfully and was discharged on the 3rd post operative day as opposed to the prolonged week long stay with open approach for such patients. 

She was advised  a graded vaginal dilation regimen, allowing for gradual expansion and adaptation of the neovagina. At her 1 year follow up, she achieved a vaginal length of 9 cm and a width of 2.5 cm, significantly improving her self identity  and self-confidence.

Empowering Patients Through Surgical Excellence

Robotic-assisted vaginal reconstruction is a game-changer in gender-affirming and reconstructive surgery, offering superior precision, reduced recovery time, and excellent functional outcomes. This case highlights the transformative impact of modern surgical innovations in restoring feminine identity and enhancing patient confidence.

Dr. Rubina Shanawaz Z | Fortis Hospital, Rajajinagar, Bengaluru