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створює піхву за допомогою ділянки товстої кишки, часто для трансгендерних жінок або вагінальної агенезії.</p>"}}},"operationIndicators":{"details":{"anesthesia":"general","days_in_clinic":7,"days_in_country":14,"rehabilitation_days":30,"satisfied_percent":78,"treatment_duration_hours":6},"illness_kind_details":{"requests_processed":110449}},"responsibleDoctor":{"id":1758,"alias":"ergin-er","name":"Ergin Er","photo":"doctor/5cd02aa7a3f4e","advisory_text":"Відзначений нагородами з пластичної хірургії обличчя та тіла; 1-е місце у конкурсі Турецького товариства пластичних хірургів.","linkedin":"","specialities":[{"id":"pls.001","name":"Пластичний хірург","illness_kind_id":38}]},"direction":{"id":38,"name":"Пластична хірургія","alias":"plastic-surgery"},"illness_kind":{"id":38,"name":{"en":"Plastic Surgery"}},"parsed_details":{"procedure_type":"surgery","fields":{"anesthesia":["general"],"back_to_work_days":{"min":42,"max":70,"unit":"days","qualifier":"Desk-type work after open abdominal 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complications."},"diagnostic_duration_minutes":null,"diagnostic_preparation":null,"diagnostic_referral_needed":null,"diagnostic_result_time_hours":null,"exercise_resume_weeks":{"min":6,"max":12,"unit":"weeks","qualifier":"Light walking earlier; strenuous exercise and heavy lifting after abdominal wall and neovaginal healing."},"final_result_months":{"min":3,"max":6,"unit":"months","qualifier":"Time for healing, mucosal adaptation and establishment of sexual function; varies with dilation adherence."},"fly_home_after_days":{"min":10,"max":21,"unit":"days","qualifier":"After discharge (5-10 nights), return of bowel function, wound check and surgeon clearance; longer if complications or long-haul flight."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":10,"max":21,"unit":"days","qualifier":"Early postoperative wound and recovery check after discharge."}},{"purpose":"assessment","requirement":"routine","after":{"min":42,"max":90,"unit":"days","qualifier":"Examination of neovagina, dilation/mold plan and intercourse clearance."}},{"purpose":"result_review","requirement":"routine","after":{"min":180,"max":365,"unit":"days","qualifier":"Longer-term review of function, stenosis and neovaginal health."}}],"indications":["Vaginal agenesis (e.g., MRKH) when dilation fails or declined","Vaginal reconstruction after resection, radiation injury, or androgen insensitivity","Gender-affirming vaginal reconstruction or revision, e.g., stenosis after vaginoplasty","Complex disorders of sex development requiring neovagina"],"main_risks":["Anastomotic leak, bowel obstruction or ileus","Infection, peritonitis, bleeding","Neovaginal stenosis or introital stricture","Excess mucus discharge, odor, diversion colitis","Fistula (rectal, bladder)","Venous thromboembolism","Necrosis of the bowel segment from vascular compromise","Prolapse of neovagina","Anesthesia risks"],"pain":"Moderate to significant postoperative abdominal and perineal pain for the first days, managed with multimodal analgesia and gradually decreasing over several weeks.","preparation":["Gynecologic, imaging (MRI/ultrasound) and colon assessment for suitable segment","Mechanical and antibiotic bowel preparation","Preoperative anesthesia assessment and fasting","Counseling on postoperative dilation/mold use and psychological readiness","Stop smoking"],"recovery_timeline":[{"phase":"Hospital stay (about days 0-10)","description":"Gradual return of bowel function and diet; catheter and vaginal mold/pack in place; pain control and mobilization.","restrictions":["No sexual activity","Limited mobility initially"]},{"phase":"Early home recovery (weeks 2-6)","description":"Fatigue and discharge gradually settle; dilation or mold regimen as directed.","restrictions":["No heavy lifting","No intercourse","No tub baths or swimming until cleared"]},{"phase":"Return to normal activity (weeks 6-12)","description":"Return to work and gradual exercise; intercourse once cleared by surgeon.","restrictions":["Avoid strenuous exertion until cleared"]},{"phase":"Long-term (3-6 months)","description":"Neovagina matures; ongoing dilation or regular intercourse maintains patency.","restrictions":[]}],"rehabilitation_days":{"min":42,"max":84,"unit":"days","qualifier":"Ordinary functional recovery after major abdominal surgery with neovaginal care; not a formal physiotherapy program."},"result_longevity":"Intended to be permanent, but long-term patency depends on regular dilation or intercourse; late stenosis or revision may occur.","revision_rate_pct":{"min":5,"max":15,"unit":"percent","qualifier":"Reoperation for introital stenosis, prolapse, or other complications over several years."},"scars":"Abdominal scars (midline or laparoscopic port sites) plus no visible external vaginal scar beyond the introitus; scar appearance varies by approach.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single operative admission for the standalone primary procedure."},"stages":[{"code":"colovaginoplasty_surgery","label":"Colon segment harvest, anastomosis and neovagina creation in one operation","after":{"min":0,"max":0,"unit":"days","qualifier":"Performed on the day of surgery."}}],"qualifier":"Usually one-stage operation; staged revision only if complications occur."},"success":{"metric":"Anatomically and functionally adequate neovagina allowing intercourse","value":90,"unit":"percent of patients","horizon":"1-2 years after surgery","population":"Adults with vaginal agenesis undergoing primary sigmoid colovaginoplasty","evidence_status":"limited"},"techniques":[{"name":"Sigmoid colon vaginoplasty (open)","suits_whom":"Most common bowel segment; adults with vaginal agenesis or reconstruction needs and healthy sigmoid colon.","recovery":"Inpatient several days, return to desk work around 6-10 weeks."},{"name":"Laparoscopic or robotic-assisted sigmoid colovaginoplasty","suits_whom":"Selected patients with suitable anatomy and surgical expertise.","recovery":"Possibly shorter hospital stay and smaller scars; neovaginal recovery similar."}],"treatment_conditions":["inpatient"],"treatment_duration_hours":{"min":3,"max":6,"unit":"hours","qualifier":"Operative time for a single primary sigmoid colovaginoplasty; varies by approach."},"initial_assessment_documents":["Pelvic MRI report","Gynecologic examination report","Karyotype and hormone panel results","Previous vaginal or pelvic surgery reports","Colonoscopy report (if available)","Recent bowel disease history summary"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single-stage surgery; stay about 2-3 weeks, including 5-10 inpatient nights. Later reviews can be remote or local."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check the qualifications of the medical team treating you","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you checked the qualifications of the medical team treating you?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C2","text":"Check that you are satisfied with the facilities and standards where you will be treated","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Are you satisfied with the facilities and standards at the clinic or hospital where you'll be treated?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C3","text":"Check that you understand the possible complications and side effects of the treatment","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Make sure you understand the possible complications and side effects that could arise from your treatment.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C4","text":"Check how your aftercare will be coordinated","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Ensure you're clear about how your aftercare will be coordinated.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C5","text":"Check that you have a face-to-face consultation with the health professional who will operate before any procedure","scope":"treatment_abroad","source":{"url":"https://travelhealthpro.org.uk/news/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"A face-to-face consultation with the health professional who will carry out any planned surgery or treatment must take place before any procedure.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C6","text":"Check that the clinic or hospital is registered with local health authorities and fully insured","scope":"treatment_abroad","source":{"url":"https://travelhealthpro.org.uk/news/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Check the clinic or hospital carrying out your procedure is registered with local health authorities and is fully insured.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C7","text":"Ask the treating team questions about your treatment","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you been able to ask them questions about your treatment?","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"A hospital marketing surgery as a holiday package","scope":"treatment_abroad","source":{"url":"https://travelhealthpro.org.uk/news/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Beware of any hospital which markets cosmetic surgery as a holiday package.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F2","text":"No meeting with the surgeon before agreeing to surgery","scope":"treatment_abroad","source":{"url":"https://travelhealthpro.org.uk/news/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Do not agree to cosmetic surgery before meeting the surgeon carrying out the procedure and visiting the hospital where the procedure will take place.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F3","text":"Advice coming from agents or sales staff rather than the treating clinician","scope":"treatment_abroad","source":{"url":"https://travelhealthpro.org.uk/news/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Do not accept advice from a travel agent, sales representatives or administrators.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F4","text":"Pressure to make a quick decision before booking","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"a hard sell a lack of information pressure to make a quick decision no discussion of possible complications no mention of aftercare","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Intestinal obstruction","urgency":"emergency","general":false,"source":{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC9366398/","host":"pmc.ncbi.nlm.nih.gov","quote":"However, sigmoid colpoplasty may cause various bowel-related complications, such as intestinal obstruction, anastomotic fistula, vaginal stenosis, artificial vaginal prolapse, colitis, and hereditary polyposis.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W2","text":"Anastomotic 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prolapse","urgency":"contact_clinic","general":false,"source":{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC9366398/","host":"pmc.ncbi.nlm.nih.gov","quote":"Complications associated with this procedure include dyspareunia, stenosis of the vaginal opening ( 3 ), intestinal obstruction, anastomotic fistula, neovaginal prolapse, colitis, hereditary polyposis, and adenocarcinoma ( 4 ).","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"Home doctor needs the prescribed medicines to continue treatment","document":"prescriptions","source":{"url":"https://travelhealthpro.org.uk/news/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"T2","text":"Home doctor needs the imaging to follow up after the procedure","document":"scans and x-rays","source":{"url":"https://travelhealthpro.org.uk/news/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"T3","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure details","source":{"url":"https://rcseng.ac.uk/patient-care/cosmetic-surgery/after-surgery/","host":"rcseng.ac.uk","quote":"After your surgery, before you leave the hospital, ask for written information about the procedure you've had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T4","text":"Home doctor needs the clinic's follow-up 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