Depth

Depth is how far a surgically built vaginal canal goes in, measured from the opening to the far end. It is the number people ask about first and the one no honest surgeon will promise beforehand, because it is decided by your own tissue and by the space that can safely be made between the bladder and the rectum.

Where you'll meet it

Everywhere in the bottom surgery conversation. It is the reason penile inversion and peritoneal pull-through are different operations, the thing vulvoplasty deliberately leaves out, and the number that forum posts compare relentlessly.

It also appears as a verdict on your recovery, because depth is not only built. It is kept.

What sets it

Two things, and neither is the surgeon's enthusiasm.

The first is the space. The canal is made by dissecting between the bladder in front and the rectum behind, and how far that can safely go is set by your anatomy and by the surgeon's judgement in the moment. Pushing past what is safe is how the rare and serious complications happen.

The second is the lining. Something has to cover the inside of that space, and there has to be enough of it. In penile inversion that lining is penile skin, sometimes extended with a graft of scrotal skin. If you went through puberty on blockers and never developed much of either, there may simply not be enough material, and this is the commonest reason a surgeon suggests a peritoneal technique instead. Peritoneum, the membrane inside the abdomen, is not limited in the same way, which is precisely its selling point.

What number should I expect?

Something in the region of twelve to fifteen centimetres is the range most surgeons work towards after penile inversion, with plenty of results above and below it. I would treat any figure quoted to you before an examination as a hope rather than a plan. Ask for a range and watch whether the surgeon hedges honestly.

A more useful question than the number is what you want the depth for. If it is penetrative sex with a particular partner or a particular object, say so plainly at the consultation, because that is a functional target a surgeon can respond to. If it is a number you saw online, it is worth asking yourself what it is doing for you.

Depth is maintained, not delivered

This is the part that catches people. A surgical canal has no biological reason to stay open, and the body will narrow it given the chance. Dilation is what keeps it, and depth lost to a stretch of not dilating is hard and sometimes impossible to recover. The depth you have at a year is a result of the operation and of the year.

Depth can also be lost to a complication rather than to neglect. Wound separation at the far end of the canal is the version surgeons worry about, because it heals by scarring and scar contracts.

Why it's on this site

Because it is the number that gets treated as a score, and it should be treated as a trade. More depth means more dissection, a longer operation and, in the peritoneal version, a second surgical team working inside your abdomen. Zero depth means vulvoplasty, a shorter operation, a lighter recovery and no dilation for the rest of your life.

For a reasonable number of people vulvoplasty is the operation that actually matches what they asked for, and the only thing stopping them choosing it is a sense that less depth is a lesser result. It is not. It is a different answer to a question you are allowed to answer for yourself.

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