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A Guide to SRS

Dr Hart's reported complication rates

During the operation the main complications are:

  • Bleeding (requirement for blood transfusions is still low at around 1-2%)
  • Rectal injury, with potential colostomy and further colorectal operations (occurs about 1% of the time)
  • Loss of blood supply to skin flaps (about 1% of the time)
  • Bladder/ureter injury requiring prolonged catheterisation or ureteric stents (1%)
  • Conversion from key-hole to open procedure during peritoneal vaginoplasty (1%)
  • Failure to complete peritoneal vaginoplasty due to intra-abdominal adhesions (<5%)

The early post-operative complications include:

  • Bleeding and labial haematomas (less than 5% requiring secondary procedures)
  • Urinary tract infections (10%)
  • Wound infections (20% - requiring antibiotics, but rarely a procedure to drain the infection); very rarely necrotising fasciitis requiring urgent surgery to debride the dead tissue (1%)
  • Wound swelling/prolapse (10%), dehiscence/separation (50%) or necrosis/tissue death (1%)
  • Pain
  • Deep vein thrombosis and/or pulmonary embolism (3%)
  • Urinary retention requiring catheterisation (5%)
  • Abdominal sepsis (2% - can require repeat abdominal procedure to wash out the infection)

The late operative complications include:

  • Altered urinary stream and direction and/or urinary incontinence
  • Urethral stenosis/scarring (that may require surgery to widen it; occurs approximately 10-15% of the time)
  • Loss of of vaginal depth/width (that may require revision surgery to widen or lengthen it over time; occurs approximately 10-15% of the time)
  • Painful sexual intercourse or clitoral stimulation (10-15%)
  • Vaginal prolapse (<5%)
  • Abdominal wall hernias (<5%)
  • Granulation tissue (50%)
  • Persistent peritoneal leakage (in PPV)
  • Peritoneal inclusion cyst/lymphocoele (where part of the peritoneal vagina walls off and can’t drain; this may require surgical drainage if it gets infected or causes pain)
  • Regret over having the operation (exceptionally rare; the main regret patients experience is choosing a particular type of vaginoplasty or labiaplasty over another)

If you have information about other surgeons and their complication rates, please contact me so they can be added to this section.