# Hypertrophic neovaginal granulation tissue after gender affirming vaginoplasty: A cautionary tale and novel treatment option

## TL;DR

A transgender woman developed severe vaginal granulation tissue after surgery and was successfully treated with laser therapy.

## Contribution

The paper introduces laser destruction as a novel treatment for severe neovaginal granulation tissue after gender affirmation surgery.

## Key findings

- Laser destruction effectively managed extensive neovaginal granulation tissue in a transfeminine patient.
- Severe granulation tissue after vaginoplasty remains a common complication with unclear treatment options.
- Standardized treatment approaches are needed for severe granulation tissue following gender affirmation surgery.

## Abstract

Approximately 25 million people worldwide, including 1 million in the United States, identify as transgender. Gender affirmation surgery (GAS), including vaginoplasty, improves quality of life but carries a 20–70 % complication rate. Granulation tissue occurs in 26 % of cases, but treatment for severe cases remains unclear. We present one transfeminine individual with extensive neovaginal granulation tissue involving 70 % of the neovagina which was subsequently treated with laser destruction. This case illustrates a novel management strategy and underscores the need for standardized treatment approaches for severe granulation tissue following GAS.