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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 fistula","urgency":"contact_clinic","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":"W3","text":"Vaginal stenosis","urgency":"contact_clinic","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":"W4","text":"Neovaginal 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 recommendations in a written discharge summary","document":"discharge summary","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"When you have treatment abroad, you must ask the treatment provider for their follow-up recommendations documented within a written discharge summary in English.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T5","text":"Home doctor needs the dates for required blood tests and follow-up appointments","document":"written aftercare plan","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"This should include any medication and doses, as well as any dates that blood tests and follow-up appointments must be carried out.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"alternatives":{"status":"ok","items":[{"id":"A1","text":"You prefer a nonsurgical treatment for your vaginal agenesis","name":"Nonsurgical dilation therapy","source":{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC7392576/","host":"pmc.ncbi.nlm.nih.gov","quote":"These include the nonsurgical Frank technique, which relies on serial dilation of a vaginal pouch.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200},"operation_id":null},{"id":"A2","text":"You prefer your own skin as the graft material","name":"Skin graft vaginoplasty","source":{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC9366398/","host":"pmc.ncbi.nlm.nih.gov","quote":"The most common colpoplasty methods include autologous grafts, such as partial-thickness or full-thickness skin grafts; peritoneal, buccal mucosa, or small bowel grafts; allogeneic human amniotic membrane insertion; or synthetic materials.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200},"operation_id":null}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"technique_details":{"status":"ok","items":[{"id":"sigmoid-colon-vaginoplasty","name":"Sigmoid colon vaginoplasty (open)","how_it_works":null,"recovery_daily":null},{"id":"laparoscopic-or-robotic-assisted-sigmoid","name":"Laparoscopic or robotic-assisted sigmoid colovaginoplasty","how_it_works":{"text":"The surgeon works through several small abdominal incisions","source":{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC8416006/","host":"pmc.ncbi.nlm.nih.gov","quote":"A laparoscopic surgeon operated using 5 small incisions (one 12 mm subumbilical portion, one 12 mm in the right lower quadrant, lateral to the inferior epigastric vessels, one 5 mm right lateral portion at the umbilical level, and two 5 mm left lateral and lower abdominal 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