Gender Reassignment Surgery CENTRE DELHI

Introduction to Gender Reassignment Surgery

For many transgender people, finding their true identity is the most valuable thing in life. With advances in medical science and more accepting attitude of the society, gender reassignment surgery (GRS) has emerged as nothing short of a boon for the transgender community. But still, a lot of confusion persist around the method. Who exactly can avail it? What are the options available? How will it impact you? Let’s take a look at GRS more closely.

Need for Gender Reassignment Surgery

Most transgender people suffer from the gender dysphoria all their lives. This can, in turn, lead to a number of psychological issues from stress to depression. Gender dysphoria can also often manifest as physical discomfort when you do not feel confident in the body you are born with.
Gender Dysphoria is a physiological distress people feel when their gender identity does not match the sex assigned to them at birth. It is primarily found among transgender people. Gender Reassignment Surgery is considered the most effective way to treat gender dysphoria. It is worth mentioning that gender dysphoria is not the same as gender nonconformity (which is the inability to identify with either gender traits).

While dealing with Gender Reassignment Surgery in transgender people, the cases are divided in two categories. Assigned Male At Birth (AMAB) undergo male-to-female Gender Reassignment Surgery while Assigned Female At Birth (AFAB) undergo female-to-male.

Considerations before Gender Reassignment Surgery

Gender reassignment is a major decision in anyone’s life – perhaps one of the biggest you could make. There are certain things you should know before opting for GRS:
Surgery is not the only option available for you. Hormonal transition can often reduce the ill-effects of gender dysphoria, without the physical toll of a surgery.
Not everyone responds the same to gender reassignment. Your experience might greatly differ from the ones you had read about. Always trust the conversation with your doctor more than online opinions.
Gender Reassignment Surgery should not be opted for the sake of it or just because you want to do it. It is a life-altering experience which might have some significant impact on your body. If you are not suffering from gender dysphoria, you might want to look for less permanent options.
Medical conditions could play a vital role in the success and recovery from Gender Reassignment Surgery. Patients suffering from serious conditions like HIV and asthma are generally dissuade from undergoing Gender Reassignment Surgery as it can cause complications. Less serious conditions like diabetes and obesity are withstand gender reassignment, but under expert medical supervision.
Gender reassignment surgery could be a costly affair. It would be wise to confirm if your health insurance cover Gender Reassignment Surgery.

What is Gender Reassignment Surgery

Assigned Male At Birth (AMAB)

ender Reassignment Surgery among trans women is much more common and even promoted in the society. The reasons are also medical; the operations involving in reconstruction of anatomy are simpler in case of AMAB.

Top Surgery
People who are AMAB suffer from gender dysphoria primarily due to lack of breasts. This could be easily remedied with a simple breast augmentation surgery. Breast augmentation is a very common surgery among women due to its cosmetic aspect, but it is also used for survivors of breast cancer. Thus, it is very easy to undergo a breast augmentation surgery.

Usually, an incision is made near the armpit and a customized implant is inserted within. The implants could be silicone (softer) or saline (cheaper); the choice entirely belongs with the patient. The surgery is short, simple and the patient recovers in just a few days.

Bottom Surgery
Bottom surgery in AMAB may involve removing the penis and testicles, giving the genital area a more feminine shape, or constructing a vagina. The purpose behind bottom surgery is either removing the testes (so that testosterone levels are lowered) or achieving a functional vagina (for sexual activity).

The two common surgeries for removing the sexual organs are:
Orchiectomy – It is a relatively simple and cheap surgical option for removing the testes. It immediately lowers the testosterone levels in the body, thereby reducing the masculine traits and aiding in hormone replacement therapy.

Scrotectomy – This surgery removes the entire scrotum, achieving results similar to orchiectomy. However, it is irreversible and makes it impossible to conduct future vaginoplasty.
In cases where the patient desires to have a vagina, vaginoplasty is the most preferred choice of surgery. Vaginoplasty is conducted by existing tissues of the patient. There are many ways of conducting a vaginoplasty, but the most common method involves penile inversion.
Here, the penis is inverted to create a vagina. The tip of the penis pushed at the inside centre and acts as a clitoris, offering the same sexual sensation as before. Finally, the scrotal skin is used to create the labia around the vagina.

Assigned Female At Birth (AFAB)

AFAB refers to trans men who were assigned female at birth but identify as a male. Female-to-male surgeries are less common in the world. This is partially due to the taboo around it, and most men choose to live with their assigned sex. But the surgery itself is also more complicated, especially constructing a functioning penis that is capable of erection.

Top Surgery
People who are AFAB would generally have a layer of chest tissues which might often develop as breasts. Removing it requires a subcutaneous mastectomy which removes the breast tissue from the chest. The surgical operation usually involves incisions, either single or double. The objective is to keep the nipples intact as they would serve a functional purpose later. The breast tissue is removed either from underneath the nipples or between the two incisions.

Bottom Surgery
Many trans men opt for hormone replacement therapy, that results in a larger clitoris. However, many other might still want to have a functioning penis in its place. Thus, bottom surgeries on AFAB people involve reconstructing the genital area to construct some kind of phallus.
Metoidioplasty – This is a great and simple surgical option for people who are already undergoing testosterone therapy and have an enlarged clitoris as a result. In metoidioplasty, the clitoris is detached from the clitoral hood, thus acting as a new phallus. It could be made functional by re-routing the urethra with a skin graft, so that the phallus could be used for urination.

Phalloplasty – This is the most common surgery used among AFAB people to construct a new phallus. Here, the entire phallus is created anew by using skin grafts from other parts of the body (like thighs and back). Phalloplasty is considered a more effective surgery as it allows the phallus to be more functional. The new phallus could be used for urination (by re-routing the urethra) and erection (with a penile implant).
Hysterectomy – Quite often, trans men might simply want to remove their existing reproductive organs due to the complication arising from them (like menstruation). Hysterectomy is one such surgery where the uterus is removed from the body.

Oophorectomy – It is used for the same reason as mentioned above. However, in oophorectomy, one or both ovaries are removed. Another surgery exists (vaginectomy) where the entire vagina is removed.

Recovery from Gender Reassignment Surgery

Recovery from Gender Reassignement Surgery greatly depends upon the type of surgery opted by the patient.
In case of most top surgeries, the patient is discharged in just a day or two. A few weeks of rest is enough to get back to normal life. Apart from strenuous physical activity, there are no restrictions.
Bottom surgeries are considerably more complicated; hence their recovery time is greater. Most bottom surgeries, in either AMAB or AFAB, would require the patient to be kept under observation for at least a week. The recovery time could vary from a month to multiple months. Physical and sexual activity are to be avoided during most of the recovery period. In case of re-routing of urethra, a catheter might be inserted for few weeks.

Life after surgery changes drastically for most people who underwent GRS. The most visible impact is less or no gender dysphoria. This, in turn, impacts their mental well being positively and they tend to be more satisfied with their lives. However, some physical impacts could persist as a side effect of the surgery and hormone transition therapy.

Conclusion Gender Reassignment Surgery

Gender Reassignment Surgery is an option for all transgenders if they want to go the distance and want to opt for either side but yes its all about choices and preferences

For further information on Gender Reassignment Surgery consult at :-

Dr. Gautam Banga

MBBS,MS,M.Ch (Urology)
Urologist, Andrologist and Genito -Urinary Reconstructive Surgeon
Contact no. : +91-9999062316 | 011-41041131
Website :

Urethral Stricture Women

Urethral Stricture Women

Urethral Stricture WomenUrethral strictures are a painful condition which is quite common among men. However, women are not completely immune to it. Even though they are very rare, urethral strictures could still appear among women. Due to their rarity, most women are unable to understand the issue when they suffer from strictures. Read on to get a better understanding of Female Urethral Stricture (FUS) and its treatments.

Urethral Stricture Women Explained

The urethra is a part of the renal system, responsible for dispelling liquid waste from the body. It is in the form of a long tube that connects the bladder to an opening of the body. The structure of the urethra differs between men and women. In men, it opens into the tip of the penis, while in women it opens into the vestibule, located between the labia minora.

Urethral strictures are essentially scars in the urethra, which causes it to become
narrow. These scars could occur due to a variety of factors. Naturally, the
narrowing of the urethra can cause many issues. Urethral strictures disrupt the
normal urinary functions and can cause moderate-to-severe pain.

Occurrence of Urethral Stricture Women

Urethral strictures are considered a male issue primarily. Occurrence in women is quite rare. Of all the women that suffer from any kind of Lower Urinary Tract
Symptoms, less than 8% are caused by Bladder Outlet Obstruction (BOO). Among the patients of BOO, only 4-18% of the cases could be termed as Female Urethral Stricture (FUS). However, note that due to its rarity, there is no fixed definition of FUS (unlike in the case of males).

It must also be mentioned that unlike male urethral strictures, scarring is not the
only cause of strictures in women. Sometimes, the urethra could become narrow
on its own. In such cases, dilations are considered the first line of

 Causes of Urethral Stricture Women

Urethral Stricture WomenUnlike urethral stricture in men, where the known causes are well-documented, things are more obscure in case of FUS. Due to the rarity of FUS cases, all the causes of urethral strictures in women is not known yet. Still, the following factors could be a cause behind the condition:

·      Trauma
(the most common cause of urethral stricture in either gender. The trauma could
occur from a physical injury or a previous treatment)

·      Radiation

·      Infection

·      Malignancy
(the presence of malignant tumour in the urethra)

·      Iatrogenic
surgery (refers explicitly to the trauma caused from previous surgery)

It is entirely possible that a woman could suffer from urethral strictures even in
the absence of above causes. This makes diagnosis tricky in case of FUS.

 Symptoms Of Urethral Stricture Women

Despite being so rare among women, Female Urethral Stricture shows stronger symptoms in them compared to men. One could expect the following symptoms when suffering from FUS:

·      Hesitancy in urination and poor flow of urine.

·      Frequent urges to urinate, usually with high urgency.

·      Painful urination (dysuria)

·      Inability to void the bladder despite frequent urination.

·      Urinary tract infection (in many cases, UTI was a direct result of FUS).

As you could see, most symptoms of urethral stricture in women is the same as men.

Urethral Stricture Women Treatment Options

Once urethral stricture is diagnosed in a female, various treatment options are
available. In some early cases, women might opt for urethrotomy – a small
operation where a surgical incision is made in the urethra. Urethrotomy is used
to provide immediate relief in case of a painful stricture, but it is not a
permanent solution.

Urethral dilation is a popular treatment option when dealing with FUS. Here, a catheter (or similar narrow tube-like tool) is inserted in the urethra to expand it. It is primarily used in cases where strictures are caused due to muscular
narrowing of the urethra. However, urethral dilation has less than 50% success
rate. In case the stricture returns after the first round of urethral dilation,
it has been observed that subsequent rounds have little or no effect. In such
cases, it is better to move to more reliable treatment options.

Urethroplasty is considered the most effective and permanent solution for urethral strictures. Considering the high success rate among men, the same treatment is also suggested for women. There are various types of urethroplasty options available for the patient. Vaginal graft and vaginal flap both take skin from around the vagina to reconstruct the urethra. They have good success rates, though the surgery is complicated. There is also a chance that the sexual activity might get impacted due to these treatments.

Buccal mucosal urethroplasty is the most common and most successful variant of the surgery. It takes tissue from the buccal mucosa (inner cheek) for reconstructing the urethra. The cheek tissue is resistant to infections and habitual to a moist environment, making it an ideal choice for the surgery.

Before the surgery, it must be ensured that the strictures in the patient are not
aggravated. In case the patient underwent dilations or urethrotomy previously,
a gap of 2-3 months must exist before the surgery. The surgery itself lasts for
2-3 hours, done under local anaesthesia.


Life After Urethral Stricture Women Treatment

After the surgery is over, the patient might be kept under observation for 24 hours.
After that, she is discharged and recommended a rest period of 1-2 weeks. The essential part of the recovery is the dissolution of the sutures on the
urethra. After a month, the patient would have to return to the clinic and
undergo tests (like urine flow and cystoscopy) to check for strictures.
Urethroplasty is found to have high (>90%) success rate among women, so the
strictures would most likely be gone.

Life after the operation is considerably better for women. The symptoms caused due to FUS largely disappear, and the urinary functions return to normal. However, patients are recommended to get a check-up every 3-6 months for the next year or two, as urethral strictures have a tendency to re-appear. Apart from that, life becomes entirely normal for patients.



Despite its rarity, urethral stricture could be a severe problem for women. Ladies should be aware of what urethral strictures are and how to deal with them.


For further information on Urethral Stricture
Women, Consult with

Dr. Gautam Banga

MBBS,MS,M.Ch (Urology)
Urologist, Andrologist and Genito -Urinary Reconstructive Surgeon
Contact no. : +91-9999062316

Address: M-4, Greater Kailash-1, New Delhi-110048, Delhi, India