MtF Gender Confirmation Surgery/Sex Reassignment Surgery colovaginoplasty is the surgical procedure using a part of the large bowel/intestine to create a functioning neovagina in a transfemale patient. This technique is uncommon in a primary procedure (no previous GCS) but is our preferred technique for patients who have had a failed first MtF GCS/SRS procedure.

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Summary of Colovaginoplasty

Surgery Time
4.5 hrs
General + Spinal / Epidural
Hospital Stay
7 nights
Reasonably Mobile
7 days
Time Off Work
6 weeks
Sleep Position
Shower after 6 days
Dressings & Garments
6-12 weeks
Exercise inc. Gym
6 weeks
Full Recovery
6-12 weeks

Reason For Surgery

  • To create good vaginal depth and calibre to permit vaginal intercourse
  • To positively address genital dysphoria associated with gender dysphoria


The majority of transgender individuals at London Transgender Clinic will achieve a good functioning neovagina with a depth of up to 20 – 22cm. The majority of our patients having this as a primary GCS/SRS have the ability to orgasm following surgery.

Colovaginoplasty FAQ’s

  • How much does it cost?

    The price of MtF GCS/SRS is approximately £34,310. This includes all your pre and post-operative aftercare up to one year, as well as your stay in hospital. For an exact quotation please book a consultation with a member of our team.

  • What happens at the consultation?

    You will meet your primary surgeon and one of our nurses who will ask you about your goals and concerns. A full medical history and examination will be done, before agreeing a plan for you and discussing the surgery and recovery and risks in detail.

    Following this consultation you will also meet with the assisting surgeon who dissects the large bowel/intestine for use in the colovaginoplasty. They will need to complete their own medical history and examination to ensure you are a suitable candidate for the colovaginoplasty surgery.

    You may be required to undergo medical investigations such as blood tests, ECG or other, as medically advised by your surgeon.

  • How do I prepare for my surgery?

    Prior to surgery you must have had a psychological and psychiatric assessment by a gender specialist to discuss the surgery and whether it is the right time for you to proceed. They must provide you with a letter of support prior to proceeding with surgery.

    Once you have your consultations and your surgery is booked, you will have a pre-operative assessment with your nurse 2 weeks before surgery, during which any outstanding questions will be answered. Your preparation for surgery will be reviewed and information will be provided regarding medications, diet, bowel preparation and post operative care.

    You will not need to stop your hormone therapy, however if you are taking oral oestrogen we will ask you to change to a transdermal patch or gel 4 weeks before your surgery.

    You must stop smoking a minimum of 2 weeks before your surgery and up to 12 weeks postoperatively.

  • What happens on the day of my surgery?

    On the day of your surgery you will wake up in the hospital as you will have been admitted the night before. You will be assessed again by your surgeons and your anaesthetist before going to the theatre. The hospital team will complete the necessary pre operative health checks.

    Following your surgery you will be bed bound and closely monitored by your surgeons and the hospital medical team. They will assist you with anything you need. You will be tired and spend most of this time resting.

  • What aftercare will be provided for me?

    LTC provides a premium aftercare service. Your primary surgeon will visit you in hospital daily for the first week. You will then be assessed in clinic 2 weeks, 6 weeks, 12 weeks, 6 months and 1 year post operatively to monitor your progress.

    You will be provided with post operative manual lymphatic drainage therapy to reduce swelling and promote better healing.

    LTC also has a nurse on call 24/7 in the event you have any emergencies following discharge from hospital. You will be seen immediately if medically required or appropriate advice will be provided.

  • What happens if there is a complication?

    In the event of a complication you will be medically assessed as soon as possible by your surgeon or a qualified member of our nursing team. In the unlikely event you need to return to theatre this will be arranged for you by our team. Hospital and anaesthetist fees may be charged, however there will be no surgical fee. Further information is outlined in our terms and conditions.

Alternative Services

We support and endorse the Guidelines for the Standards of Care for transgender, trans-individuals set out by the World Professional Association for Transgender Health (WPATH).


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