Vaginoplasty in Switzerland: tightening, creation and affirmation

The word vaginoplasty covers very different procedures that have in common the modification or creation of the vagina. For a woman who, after several deliveries, feels persistent laxity despite rehabilitation, it refers to tightening of the vagina and reconstruction of the perineum. For a young woman born without a vagina, as in Mayer-Rokitansky-Küster-Hauser syndrome, it refers to the creation of a functional vagina. For a trans woman, it refers to gender-affirming genital surgery. These three situations have different expectations, techniques and teams. This page presents them one by one: indications, techniques, procedure, recovery, risks, insurance coverage in Switzerland and where to consult in the 26 cantons. For an overview of the intimate area, see our guide to intimate surgery.

Tightening vaginoplasty reduces the diameter of the vagina and reconstructs the perineum after childbirth; it is considered after well-conducted rehabilitation has failed, is performed under spinal or general anaesthesia and requires six to eight weeks without intercourse. Creating a vagina in women born without one relies first on progressive dilation, with surgery reserved for failure or the patient's preference. Gender-affirming vaginoplasty creates a vulva and vagina in trans women; it requires a hospital stay of about a week and long-term dilation. The last two are covered by compulsory insurance according to medical criteria; purely cosmetic tightening is not. Budget guidelines in percentages are on our page on vaginoplasty prices in Switzerland.

This distinction is essential, as online searches often mix these situations up. A woman looking for information on tightening after childbirth does not need the same information as a teenager who has just been told she has no vagina, or a trans woman preparing for surgery. Each part of this page can be read independently.

The vagina is a muscular, elastic canal about seven to ten centimetres long at rest, connecting the vulva to the cervix. Its wall is made up of a folded, highly extensible mucosa, a muscle layer and a supporting tissue called fascia. In its lower third, it is surrounded by the pelvic floor muscles, in particular the levator ani muscles, which form a sling around its opening.

The perineal body, located between the vaginal opening and the anus, is the anchoring point for many muscles. It is this that is often stretched or torn during childbirth, and this that is reconstructed during perineoplasty. Its strength determines the closure of the vaginal opening and the support of the back wall.

The vulva refers to all the external genitals: the mons pubis, labia majora, labia minora, the clitoris and its hood, the urinary opening, the entrance to the vagina, called the vestibule, and the glands that provide part of the lubrication. It varies greatly from woman to woman in shape, size and colour.

During tightening vaginoplasty, the vulva is in principle not altered, unless associated procedures are planned. The vaginal opening and perineum, however, are reshaped. During gender-affirming vaginoplasty, all these structures are created from existing genital tissue, with the aim of obtaining a natural-looking, functional vulva.

Perineal repair after childbirth is one of the oldest gynaecological operations, described as early as the 19th century. Creating a vagina in women born without one first relied on skin grafts, then on techniques using the peritoneum or a bowel segment. In the mid-20th century, gynaecologists showed that progressive dilation, without surgery, allowed a functional vagina to be created in many patients.

Gender-affirming vaginoplasty developed from the 1950s, with the penile skin inversion technique, still the most widely used today in refined forms. More recently, techniques using the peritoneum by laparoscopic or robotic approach have widened the options. Finally, cosmetic tightening vaginoplasty spread with cosmetic intimate surgery from the 2000s, with ongoing debate about its indications.

A feeling of vaginal laxity is a common complaint after one or more vaginal deliveries, sometimes also after menopause. Women describe it in different ways: the impression of a vagina that is "too wide", reduced sensation during intercourse, air that enters and comes out with an embarrassing noise, a tampon that does not stay in place, or the feeling that their partner feels less. These symptoms are real and can weigh on intimate life and self-esteem.

They can have several causes, often combined: stretched pelvic floor muscles, injury to a levator muscle during a difficult delivery, a poorly healed tear or episiotomy that widens the vaginal opening, weakening of the partition between the vagina and rectum, or menopausal hormonal changes that make the tissues less toned. Identifying the cause is essential for choosing the right treatment.

A feeling of laxity, leakage, pain during intercourse or a troublesome scar often remain unspoken for years. Women cite embarrassment at talking about it, the idea that these problems are the normal price of motherhood, fear of an intimate examination or of being judged superficial if the complaint concerns sexuality. Some think there is no solution.

Yet these problems are common and legitimate, and most have a solution, often non-surgical. A simple sentence is enough to start the conversation with your gynaecologist, midwife or GP. Sexual health centres also offer a confidential first contact. The earlier the question is asked, the more numerous and simpler the options.

Many women complain, after childbirth, that air enters the vagina during intercourse, sport or yoga, then comes out with an embarrassing noise. This phenomenon, sometimes called vaginal flatulence, is harmless but often very troublesome. It generally reflects a widened vaginal opening or a weakened perineum that no longer closes the opening properly.

Pelvic floor rehabilitation often improves closure of the vaginal opening. Certain positions during intercourse or exercise also limit air entry. When discomfort persists despite rehabilitation and a gaping opening is found on examination, perineoplasty, sometimes on its own, often gives a good result for this specific symptom.

During vaginal delivery, the perineum stretches considerably and can tear. Tears are classified into four degrees according to their depth. First-degree tears involve only the skin and mucosa; second-degree tears involve the perineal muscles; third-degree tears reach the anal sphincter; fourth-degree tears extend through to the rectal mucosa.

Tears are repaired in the delivery room, and the most significant ones in theatre. They most often heal well, but some women retain discomfort. Third- and fourth-degree tears warrant specialist follow-up and rehabilitation, and must be mentioned at a consultation for tightening, as they change the surgical strategy.

These factors do not prevent vaginal delivery, and obstetric teams adapt their practice to protect the perineum. They do, however, explain why some women retain after-effects despite a well-managed delivery, and why there is no reason to feel guilty.

An anal sphincter injury during childbirth can cause leakage of wind or even stools, urgency or constant discomfort. These symptoms are often kept quiet out of shame, yet they can be treated. An endoanal ultrasound assesses the sphincter, and specific rehabilitation, sometimes with biofeedback, considerably improves continence in many women.

When discomfort persists, surgical repair of the sphincter, called sphincteroplasty, may be offered, sometimes combined with perineoplasty. These procedures fall within colorectal surgery or urogynaecology and are covered by basic insurance. When planning a further delivery, a previous sphincter injury is an important factor in discussing the mode of delivery.

During some deliveries, particularly the first, with a large baby or forceps extraction, part of the levator ani muscle can detach from its insertion on the pelvic bone. This injury, called avulsion, often goes unrecognised. It widens the space between the muscles around the vagina and increases the risk of prolapse and a feeling of laxity.

Rehabilitation strengthens the remaining fibres and improves function, but cannot reattach the muscle. Tightening surgery partly compensates for this defect by strengthening the tissues and perineum, without being able to repair it directly. Knowing about this injury, thanks to ultrasound, allows expectations to be adjusted and the most suitable strategy to be chosen.

An episiotomy is an incision in the perineum made during delivery to help the baby out in certain situations. It is now performed much more selectively than in the past. Its scar most often heals without difficulty, but it can remain painful, thick or asymmetric, or leave a deformed vaginal opening, with pain during intercourse.

Scar massage, pelvic physiotherapy and sometimes local treatments improve most situations. When the scar remains troublesome beyond a year, surgical revision, often combined with perineoplasty, restores a supple perineum and a harmonious vaginal opening.

A feeling of heaviness, a lump at the vaginal opening or a dragging sensation at the end of the day suggests prolapse — the descent of a pelvic organ — rather than simple vaginal laxity. The two can coexist. The distinction is important, as prolapse of the bladder or uterus is not corrected by tightening vaginoplasty, but by specific surgery, after any failed rehabilitation or pessary.

A gynaecological examination, carried out at rest and while bearing down, makes the distinction. If prolapse is present, the surgeon may propose treating it at the same time as perineoplasty. Our guide to intimate surgery presents prolapse treatment.

Realisation

A few months after childbirth, the discomfort persists: reduced sensation, air escaping, sometimes leakage.

The first consultation

Her gynaecologist examines her, reassures her about how common these problems are and prescribes pelvic floor rehabilitation.

Rehabilitation

For several months, she attends sessions and does her exercises at home. The leakage disappears and sensation improves.

The review

A year after the birth, she reviews things with her gynaecologist. If the discomfort persists and a defect is identified, a surgical consultation is offered.

The decision

She takes time to think, talks it over with her partner, checks coverage and chooses a suitable time.

The procedure and afterwards

After a perineoplasty, a few weeks of recovery, then consolidating rehabilitation.

This journey often takes more than a year between childbirth and any surgery. This time is not wasted: it allows the tissues to recover, rehabilitation to take effect and the decision to mature. Many women find at the end of this period that they no longer need a procedure; those who do have surgery do so with more precise expectations, which favours a satisfying result. At every stage, the gynaecologist, midwife and physiotherapist remain available to answer questions, adjust the programme or refer to a specialist if a new symptom appears.

The interview

The doctor asks how long the discomfort has existed, in what circumstances it occurs, about your deliveries, urinary and bowel symptoms, and your expectations.

The examination

They observe the vaginal opening at rest and on effort, assess the strength of muscle contraction, look for descent of the wall or an organ and examine any scars.

Questionnaires

Validated questionnaires measure the discomfort and its impact on sexuality, and allow comparison before and after treatment.

Perineal ultrasound

In some cases, it shows the levator muscles and can reveal detachment of one of them after childbirth, as well as the state of the anal sphincter.

Perineal ultrasound is a painless examination carried out by placing a probe on the outside of the perineum, sometimes supplemented by a probe placed at the entrance to the vagina or anus. It shows the levator muscles, the muscle attachments to the bone, the mobility of the bladder and urethra, the thickness of the perineum and the state of the anal sphincter. You are asked to contract, relax, then bear down, to observe the movements.

The information obtained helps understand the origin of laxity, predict the effectiveness of rehabilitation and choose the surgical procedures. Detachment of a levator muscle, for example, explains why some women make little progress despite diligent rehabilitation.

Before any surgery, pelvic floor rehabilitation with a specialist physiotherapist is recommended. It strengthens the muscles around the vagina, improves their coordination and endurance, and teaches you to contract them during intercourse. In many women, it considerably reduces the feeling of laxity and improves sensation. It also treats the urinary leakage often associated with it. It is covered by basic insurance on prescription.

It is advisable to wait at least six to twelve months after the last delivery, and often until breastfeeding has ended, before judging that discomfort persists. During breastfeeding, lower oestrogen makes the tissues thinner and drier, which temporarily accentuates symptoms. Surgery is only considered if discomfort persists despite well-conducted rehabilitation and an anatomical defect is identified.

When the pelvic floor muscles are very weak or difficult to feel, the physiotherapist may use electrical stimulation, which makes the muscle contract with a gentle current through a probe, and biofeedback, which displays the contraction on a screen. These tools help learn the correct contraction, then strengthen it. They are part of rehabilitation covered on prescription. Some devices exist for home use, alongside sessions, on the physiotherapist's advice.

During home visits and the postnatal consultation, the midwife is often the first to examine the perineum after the birth and to hear concerns: pain on a scar, a feeling of openness, leakage, apprehension before resuming intercourse. She advises on care, contraception and when to start rehabilitation, and refers to a gynaecologist or physiotherapist if needed. Do not hesitate to ask her all your questions, even those that seem embarrassing.

Women who have given birth by caesarean can also experience pelvic floor changes linked to the pregnancy itself: the weight of the uterus, hormonal changes and abdominal pressure put strain on the muscles for months. Stress urinary leakage and reduced tone are therefore possible even without vaginal delivery, but perineal injuries and a widened vaginal opening are much rarer. Rehabilitation after the birth remains useful.

Resuming running, jumping or heavy weight training too soon puts strain on a still-fragile pelvic floor and can worsen laxity or leakage. It is advisable to start with walking and gentle exercise, do pelvic floor rehabilitation, then gradually resume impact sports, generally not before three to four months, according to the physiotherapist's assessment. Leakage, heaviness or a feeling of a lump during exertion are signals to slow down and seek advice.

Sportswomen in high-impact disciplines, such as running, trampolining, gymnastics or CrossFit, are particularly prone to stress urinary leakage, sometimes without having had children. After childbirth, they may feel laxity more during exertion. Specific rehabilitation built into training and work on managing abdominal pressure give good results. After vaginoplasty, impact sports are resumed gradually, on the physiotherapist's advice.

Coaches and fitness trainers are increasingly aware of these issues; talking to them allows sessions to be adapted during the recovery period, without giving up the sport that contributes so much to physical and mental well-being day to day.

After a birth, the return of sexual activity varies greatly. Fatigue, breastfeeding, hormone-related vaginal dryness, a tender scar, fear of pain and changes in the couple's life influence desire and comfort. Many women find first intercourse different, without this reflecting a lasting anatomical problem.

A lubricant, patience, positions that do not put pressure on the scar and open communication with your partner help. If pain persists beyond a few months, or the feeling of laxity remains troublesome after rehabilitation, a consultation allows you to take stock. Surgery is only considered after this recovery period.

After menopause, falling oestrogen thins the vaginal mucosa, makes it drier and less elastic, and reduces the tone of the supporting tissues. Some women then feel discomfort during intercourse, more often linked to dryness than to true widening. Local hormone treatment, vaginal moisturisers and lubricants, and rehabilitation greatly improve these symptoms. Tightening surgery only makes sense if there is a real anatomical defect, and it must take tissue fragility into account.

Older women also consult for a feeling of laxity, discomfort during intercourse or a gaping vaginal opening, often associated with early prolapse. In these women, tissue quality — thinned by menopause — and the presence of other pelvic floor problems guide care. Local hormone treatment for a few weeks before the procedure improves healing.

Surgery is often combined with treatment of prolapse or incontinence. The aim is everyday comfort and, for sexually active women, pleasurable intercourse; the diameter is calibrated accordingly. Age is not a contraindication in itself, but general health and treatments are carefully assessed.

Vaginal dryness is common during breastfeeding, after menopause, after certain cancer treatments or with certain contraceptive pills. It makes intercourse uncomfortable or even painful and can be mistaken for an anatomical problem. In most cases, it is simple to treat.

Low-dose local oestrogen is well tolerated by most women, often including after certain cancers, on the oncologist's advice. It also improves comfort after vaginoplasty in post-menopausal women.

Vaginismus is an involuntary contraction of the muscles around the vaginal opening that makes penetration difficult, painful or impossible. It may have existed since first intercourse or appear later, for example after a difficult delivery or a painful experience. It is not a vagina that is too narrow, and surgery is not a solution.

Its treatment relies on pelvic physiotherapy, with work on relaxation and awareness of the muscles, progressive exercises with dilators, and sexological or psychological support. Results are good in the vast majority of women. A woman consulting for tightening must be examined carefully so as not to miss pain of this kind, which surgery would worsen.

Pain felt deep inside during intercourse generally has nothing to do with the diameter of the vagina. It may reflect endometriosis, adhesions after abdominal surgery, an ovarian cyst, infection or pelvic muscle tension. Tightening would not relieve it and could worsen the problem. A gynaecological assessment, sometimes with an ultrasound or MRI, identifies the cause and the right treatment.

Posterior colporrhaphy

The surgeon makes an incision in the back wall of the vagina, reinforces the fascia between the vagina and rectum with stitches, removes excess mucosa if needed, then closes. This procedure reduces the diameter of the vagina and corrects any rectocele, i.e. a bulging of the rectum into the vagina.

Levator myorrhaphy

They bring together the inner edges of the levator ani muscles to tighten the sling around the vagina. This procedure is effective but carries a risk of pain during intercourse if too tight; many surgeons use it sparingly in sexually active women.

Perineoplasty

They reconstruct the perineal body between the vagina and anus, bring the superficial muscles together and tighten the vaginal opening. It is often the procedure that brings the greatest perceived benefit, particularly when the vaginal opening is gaping.

Associated procedures

Depending on needs, repair of the front wall, a labiaplasty or revision of an episiotomy scar can be carried out at the same time.

The surgeon calibrates the diameter obtained during the procedure, often using their fingers or an instrument, to avoid excessive narrowing, which would be the main cause of dissatisfaction.

During tightening, other procedures can be combined to improve comfort or harmony in the area: labia minora reduction if they cause discomfort, fat transfer to labia majora that have lost volume, or revision of a vulvar scar. Combining them avoids a second anaesthetic but lengthens recovery and increases swelling in the first few days. The surgeon helps you decide what is really useful.

Laser or radiofrequency treatments are offered for vaginal laxity, with the promise of "rejuvenating" tissues without surgery in a few sessions. They work by heating the mucosa to stimulate collagen production. Available studies remain limited: often short-term, on few patients, with variable results sometimes comparable to a sham treatment. Health authorities have warned against unproven claims and reported side effects such as burns, scarring or pain.

These treatments are not reimbursed. They do not correct a muscle injury, a rectocele or a torn perineum. If you are offered one, ask what studies support its effectiveness in your situation, how many sessions will be needed, how long the effect lasts and what is planned in the event of a complication.

• A full gynaecological examination is carried out before any proposal.
• Alternatives, including rehabilitation, are presented.
• The limits of the scientific evidence are honestly explained.
• The number of sessions, their total cost and the expected duration of effect are specified in writing.
• Possible side effects are described.
• No promise of "rejuvenation" or guaranteed improvement in pleasure is made.

If any of these conditions is missing, take time to seek another opinion before committing to a non-reimbursed treatment.

The procedure is done under spinal or general anaesthesia and takes one to two hours depending on the procedures. A urinary catheter is sometimes left for a few hours, and a vaginal pack until the next day to limit bleeding. You go home the same day or the next. The stitches are dissolvable. Slightly bloodstained discharge is normal for two to four weeks.

A firmer or slightly tender area at the scar is normal for a few months. Gentle massage, once the skin has closed and with the surgeon's approval, helps soften it.

Pain during intercourse

This is the most feared complication, linked to excessive narrowing, a contracting scar or a muscle that is too tight. It often improves over time with physiotherapy and dilators; rarely, revision is needed.

Haematoma and infection

Possible as after any surgery; they are generally simple to treat.

Wound breakdown

Part of the scar can open, notably with exertion or constipation; it most often heals on its own.

Rectovaginal fistula

An abnormal connection between the rectum and vagina, exceptional but serious, requiring repair.

Insufficient result

The feeling of laxity may partly persist, especially if a deep muscle injury could not be corrected.

A minority of women retain pain several months after vaginal or perineal surgery, at a scar, at the vaginal opening or during intercourse. The causes vary: a contracted scar, a muscle tightened too much, a small irritated nerve area, reflex tension of the pelvic floor muscles, or a granuloma around a stitch. Careful examination often identifies the cause.

Care combines pelvic physiotherapy, scar massage, dilators, local pain treatments, sometimes injections and, more rarely, revision surgery. Sex therapy helps break the cycle of pain, apprehension and muscle contraction. Do not wait to talk about it: the earlier treatment begins, the better the results.

Pregnancy after tightening vaginoplasty is entirely possible. The question concerns delivery: a further vaginal delivery can stretch the tissues again and alter the result. Some women and obstetricians then discuss a caesarean; others prefer vaginal delivery, accepting this risk. There is no single rule; the decision is made with the obstetrician. That is why it is often advised to wait until you have completed your plans for pregnancy before tightening.

The result of tightening and perineoplasty is lasting, but depends on several factors. A further vaginal delivery can alter it. Menopause makes the tissues thinner. Excess weight, chronic coughing, constipation and repeated heavy lifting increase pressure on the perineum. A pelvic floor maintained with regular exercise supports the result in the long term.

Mayer-Rokitansky-Küster-Hauser syndrome, often abbreviated to MRKH, affects about one in four to five thousand female births. The girls concerned are born without a uterus and with an absent or very short vagina, while their ovaries function normally. They therefore have a normal puberty, with breast and hair development, but no periods. It is generally this absence of periods, at around fifteen or sixteen, that leads to the diagnosis.

The diagnosis is often a shock, for the girl and her family, as it touches on sexuality, fertility and identity. It must be given by an experienced team, with time, explanations and psychological support. Patient associations offer valuable support. Treatment of the vagina is never urgent: it is offered when the young woman feels ready, often at the end of adolescence or in early adulthood.

When absent periods suggest MRKH syndrome, a pelvic ultrasound and often an MRI confirm the absence of a uterus and the presence of normal ovaries. A hormone assessment and chromosome analysis distinguish other situations, such as androgen insensitivity. As the syndrome is sometimes accompanied by abnormalities of the kidneys, skeleton or, more rarely, hearing, a kidney ultrasound and suitable assessment are generally offered. These tests are carried out in a caring setting, explaining each step to the girl.

Learning that their daughter has no uterus or vagina is a shock for parents too. Many feel guilty, even though nothing during the pregnancy is the cause. Others immediately worry about their child's sexuality and fertility. It is important to take time to take in the information, ask the team all your questions and seek support.

For the girl, the way those around her react matters a great deal. Giving her space to feel and express her emotions, respecting her pace, avoiding dramatising or, conversely, minimising, and encouraging her to meet other young women affected helps build a positive self-image. Decisions about treatment are hers; parents support her.

Young women with MRKH syndrome often wonder what to tell their friends or a future partner, and when. There is no single right answer: some talk about it openly, others only to people they trust, others wait for a stable relationship. What matters is staying in control of your own story.

First relationships may come with apprehension, especially if dilation treatment is not complete. Intimacy is not limited to penetration, and many forms of sexuality remain possible. Psychological or sexological support, and contact with other young women affected, help approach these stages with confidence.

University centres and some hospitals have clinics dedicated to adolescents, where questions about puberty, absent or painful periods, genital malformations and sexual health are addressed in a suitable setting. Teams take time to explain, involve parents if the girl wishes, and respect her modesty and pace. This is generally where MRKH syndrome is diagnosed and treated, with psychological support.

Complete androgen insensitivity syndrome is a variation of sex development: the person has XY chromosomes and testis-type gonads, but their body does not respond to male hormones. They develop with a female appearance and most often a female identity. The vagina is often shorter than average and there is no uterus.

As in MRKH syndrome, dilation is the first-line treatment when the vagina is too short for comfortable intercourse, with surgery reserved for failure. Overall care, which includes decisions about the gonads, hormone treatment and psychological support, takes place in centres specialising in variations of sex development, respecting the person's autonomy and pace.

Pelvic radiotherapy, used for certain cancers of the cervix, endometrium, rectum or anus, can over time cause narrowing and shortening of the vagina, as well as significant dryness. Some cancer surgery also removes part of the vagina. These after-effects make intercourse and gynaecological examinations difficult.

Prevention relies on regular use of dilators, started in the weeks after radiotherapy ends, moisturisers and sometimes local oestrogen. When narrowing has set in, progressive dilation, physiotherapy or even reconstructive surgery may be offered. Swiss oncology centres often have consultations dedicated to sexual health after cancer; do not hesitate to raise the subject.

The method recommended as first-line treatment for creating a vagina in women with MRKH syndrome is not surgical. It involves applying gentle, progressive pressure several times a day with dilators of increasing size to the small depression at the vaginal opening. The tissues in this area are highly extensible and gradually deepen.

With support from a specialist team, often a gynaecologist and a physiotherapist, this method allows the vast majority of patients to obtain, within a few months, a vagina deep enough for intercourse. It requires motivation and regularity, and psychological support makes this journey much easier. Regular intercourse, when possible, then helps maintain the result.

When dilation does not give a sufficient result, or when the patient does not wish to or cannot continue, several surgical techniques exist. All then require a period of dilation to maintain the vagina created.

The choice depends on anatomy, the team's experience and the patient's preferences. These procedures are performed in university centres or highly specialised gynaecology departments. They are covered by insurance, and in young patients, disability insurance (AI) may contribute under congenital conditions, according to the conditions in force.

With a functional vagina, obtained by dilation or surgery, the vast majority of women with MRKH syndrome have a satisfying sex life, with desire, pleasure and orgasm. The clitoris and vulva are normal. Sex therapy can help overcome apprehension about first intercourse.

The absence of a uterus prevents carrying a pregnancy. As the ovaries function, these women can have genetically related children by other routes, which depend on the law: surrogacy is prohibited in Switzerland. Uterus transplantation, performed in a few centres worldwide, remains at the research stage. Adoption is another route. These questions are weighty, and specialist psychological and medical support is invaluable. See our guide to IVF and assisted reproduction.

A vagina created by dilation or surgery needs to be maintained, especially in the first few years. Regular intercourse is often enough; in its absence, periodic dilation a few times a week maintains depth. After surgery, the dilation schedule is set by the team and gradually becomes less frequent. If maintenance is interrupted for a long time, narrowing can occur, but it can generally be recovered by gradually resuming dilation.

For many trans women, vaginoplasty is a major step in their pathway, bringing the body into line with their identity. It creates a vulva, with labia majora and minora, a sensitive clitoris and a vagina, from existing genital tissue. It is a major procedure requiring preparation, a hospital stay of about a week and commitment to care for several months, then in the long term.

Not all trans women want this surgery, and no administrative process requires it in Switzerland: since 2022, changing legal sex in the civil register is done by simple declaration. The decision is personal. It is prepared with a multidisciplinary team, generally including a psychiatrist or psychologist, an endocrinologist, the surgeon and often a pelvic physiotherapist. For the other stages of the pathway, see our pages on facial feminisation and body feminisation.

Psychological support

An assessment confirming gender dysphoria and capacity to consent is generally required, particularly for insurance coverage. It should not be an obstacle, but a support.

Hormone therapy

Most teams require hormone therapy for at least twelve months, unless contraindicated. It prepares the tissues and allows the experience of bodily changes to be lived.

Permanent hair removal

The hairs on the area that will be used to create the vagina must be permanently removed before the procedure, by laser or electrolysis, over several months. Otherwise, hairs can grow inside the vagina, causing discomfort and infections.

Physical preparation

Stopping smoking, stabilising weight and controlling chronic diseases. Some teams set a maximum body mass index, as excess weight increases complications.

Fertility preservation

Before surgery, which removes the testicles, sperm storage may be offered if plans for a child are being considered, ideally before starting hormone therapy.

This assessment can extend over several months. Its purpose is not to delay the procedure, but to make it safe and prepare recovery as well as possible.

These stages often overlap, and waiting times vary between centres. Planning hair removal and the cost approval request in advance avoids delaying the procedure once the decision is made.

Clitoroplasty is performed from part of the glans, preserved with its nerves and blood vessels, which allows erogenous sensation to be maintained. The testicles are removed and the urethra shortened and repositioned. The prostate is kept. The choice of technique is made with the surgeon according to anatomy, depth wishes, the amount of skin available and the team's experience.

Before gender-affirming surgery, an important decision concerns whether to create a vaginal cavity, and the desired depth. Full vaginoplasty allows vaginal penetrative intercourse but requires lifelong dilation and carries more risks. Vulvoplasty, which creates a vulva without a vagina, offers simpler recovery and fewer complications, but does not allow vaginal penetration.

The criteria for choosing are personal: wishes regarding sexuality, ability to devote time to dilation, health and the amount of skin available. Some women first choose vulvoplasty, knowing that vaginoplasty remains possible later with suitable techniques. Talking about it openly with the team and, if needed, with a psychologist or sex therapist helps you make the choice that suits you.

The procedure takes three to six hours depending on the technique, under general anaesthesia. On leaving theatre, a pack or stent maintains the shape of the vagina, and a urinary catheter is in place. The first few days are spent in bed or with limited mobilisation, to protect the grafts. Around the fifth to seventh day, the dressing and pack are removed, the catheter taken out, and the team teaches dilation and care. Discharge is generally after six to ten days.

• Loose, comfortable clothing, pyjamas that open easily.
• Loose cotton underwear and thin sanitary pads.
• A ring cushion for sitting.
• Things to do during the days in bed: books, tablet, headphones.
• A phone charger with a long cable.
• Identity documents, insurance card, cost approval.
• A list of your medicines and hormones.
• For going home: dilators, lubricant and gentle washing products, according to the list given by the team.

At home, prepare a calm, clean space for dilation, with a towel, lubricant, wipes and a bin within reach. Organise simple meals for the first few weeks and, if possible, the presence of someone close. Keep the dilation and appointment calendar clearly visible. Many patients appreciate being able to reach the team's nurse easily with practical questions; ask for her contact details before discharge.

After gender-affirming vaginoplasty, the created vagina tends to narrow and shorten during healing. Dilation, using dilators of increasing size, is essential to maintain its depth and diameter. It is very frequent at first, several times a day, then spaced out over the months, but remains necessary for life at a reduced rate, unless regular intercourse is enough to maintain the vagina.

Dilation requires time and discipline, especially in the first few months, when it takes up several hours a day in total. It is important to take this into account when organising work and personal life. Pelvic physiotherapy helps carry it out without pain, by learning to relax the muscles.

In the first few months, the day is often organised around dilation and care. A typical routine includes several dilation sessions of about fifteen to thirty minutes each, followed by vaginal rinsing if the team recommends it, gentle washing and a change of pad. Between sessions: rest, walking and calm activities.

Many patients find it useful to plan fixed time slots, keep a dilation diary and prepare a clean, comfortable space in advance. Fatigue, common in the first few weeks, gradually decreases. If dilation becomes painful, bleeds heavily or becomes impossible, contact the team without delay.

Dilators are smooth rods, generally made of medical-grade silicone or rigid plastic, of increasing length and diameter. They are used to create a vagina in MRKH syndrome, to maintain it after gender-affirming vaginoplasty, to treat narrowing after surgery or radiotherapy, or as part of vaginismus treatment.

• Choose the model recommended by your team, suited to your situation.
• Wash them with lukewarm water and mild soap after each use, then dry them.
• Use a water-based lubricant compatible with silicone.
• Do not share them.
• Replace them if they show cracks or rough patches.
• Store them in a clean pouch, away from dust.

Dilators prescribed in a medical context, notably in MRKH syndrome or after gender-affirming vaginoplasty, may be covered; ask your insurer.

The pelvic floor muscles surround the new vagina and play an important role in successful dilation and the quality of intercourse. When they are tense, dilation becomes painful and difficult, which can lead to spacing it out and encourage narrowing. Pelvic physiotherapy, ideally started before the procedure, teaches you to relax them, breathe correctly and find the right angle for dilation.

After the procedure, the physiotherapist also helps manage urinary problems, pain and the return to intimacy. Several Swiss centres include this care in the gender-affirming vaginoplasty pathway; it is covered by basic insurance on medical prescription.

Narrowing

The most common long-term complication, encouraged by insufficient dilation. It is treated by resuming dilation, sometimes by surgery.

Urinary problems

Deviated stream, difficulty urinating, urinary infections and, more rarely, narrowing of the urethra.

Granulation tissue

Small buds of tissue that bleed easily, common in the first few months, treated locally.

Partial graft loss

Part of the skin may not take, which slows healing.

Rectovaginal fistula

Rare but serious, it requires specialist management.

Cosmetic touch-ups

Labial asymmetry or the appearance of the clitoris or vaginal opening may justify a second procedure, often a few months later.

After gender-affirming vaginoplasty, the urethra is shortened and repositioned. At first, the urinary stream may be deviated or sprayed, requiring more wiping; it often improves as swelling decreases. Urinary infections are more common in the first few months, because of the catheter and the proximity of scarred areas.

More rarely, narrowing of the urinary opening makes urination difficult or slow; it is treated with a minor procedure. Burning when urinating, frequent urges or fever require consultation. Drinking enough and urinating regularly help prevent infections.

A second, lighter procedure is common a few months after gender-affirming vaginoplasty, to refine the appearance of the vulva: reducing or reshaping the labia, adjusting the clitoral hood, correcting asymmetry, widening the vaginal opening or treating excess tissue. Some teams plan it from the outset; others offer it depending on the result. It is often done as an outpatient procedure, with a short recovery.

The vast majority of trans women who have had surgery retain erogenous sensation thanks to preservation of the glans nerves during clitoroplasty, and many report being able to reach orgasm. Sensation can take several months to return and stabilise. A vagina created by skin inversion does not produce significant natural lubrication; a lubricant is needed during intercourse.

Intercourse generally resumes after three months, with the team's approval, gently. Sex therapy can help discover this new body. Overall satisfaction reported in studies is high, and regret remains rare when the decision has been well prepared.

Whether after tightening, creation of a vagina or gender-affirming vaginoplasty, first intercourse is often awaited with a mixture of impatience and apprehension. A few tips help: wait for the team's approval, choose a relaxed moment, use plenty of lubricant, favour a position in which you control depth and pace, and do not hesitate to stop if pain occurs.

Sensations may differ from what you knew or imagined; they change over the weeks. Communicating with your partner, before and during, makes this moment much easier. If pain persists or apprehension holds you back, mention it at the check-up: physiotherapy, dilators or sex therapy often bring rapid help.

After gender-affirming vaginoplasty, regular follow-up remains useful: checking healing and depth, managing any complications and adjusting dilation. As the prostate is kept, its follow-up follows the usual age-related recommendations; it is important to inform doctors of this particular feature. Sexually transmitted infections remain possible and warrant the same precautions as for anyone. The neovagina can be examined by a gynaecologist familiar with the technique used.

Several resources exist in Switzerland to support women affected by these procedures. Sexual health and family planning centres offer a listening ear and referral in every canton. Associations of women with MRKH syndrome or other variations of sex development offer support and meetings. For trans people, national associations such as Transgender Network Switzerland, as well as regional ones, support medical, legal and social steps. Specialist hospital teams can direct you to these resources.

A vagina created by skin inversion does not have the same flora as a natal vagina: skin does not produce the secretions and acidity that usually protect the vagina. Discharge, sometimes foul-smelling, is common, particularly in the first few months and when lubricant residue is present. The rinsing recommended by the team, gentle hygiene and moderate use of suitable lubricants limit these inconveniences.

A vagina lined with peritoneum or bowel has a different lining, with its own secretions. In all cases, unusual discharge, bleeding or pain warrant consultation. A gynaecologist familiar with the technique used can examine the neovagina and adapt advice.

Over the years, a neovagina created by skin inversion generally remains stable if maintained, by intercourse or periodic dilation. The skin lining it ages like skin elsewhere, without the menopausal hormonal changes that affect natal vaginal mucosa. A vagina lined with peritoneum or bowel behaves in its own way, which the team will explain. Regular gynaecological follow-up, with a professional informed of your history, allows narrowing, irritation or any abnormality to be detected and treated early.

In some trans men, genital surgery includes a colpectomy, i.e. removal or closure of the vagina, often performed at the same time as a metoidioplasty or phalloplasty, or after a hysterectomy. It prevents residual bleeding and secretions, and is necessary when the urethra is lengthened. These procedures are performed by teams specialising in gender-affirming surgery, mainly in university centres, and follow the same principles of preparation and coverage as other gender-affirming surgery.

Nathalie, 38

Three children, a feeling of laxity and air escaping during intercourse. Nine months of rehabilitation improve the urinary leakage but not the vaginal opening, which remains gaping. A perineoplasty on its own gives her the change she wanted.

Céline, 44

A tear during her second delivery left a painful scar. Physiotherapy and scar massage considerably improve the situation; no surgery is needed in the end.

Léa, 17

Absent periods; MRKH syndrome is diagnosed. After a period of psychological support, at eighteen she begins a dilation programme followed by a gynaecologist and physiotherapist, with a good result within a few months.

Marion, 23

Also with MRKH syndrome, dilation did not work for her. A laparoscopic technique, followed by dilation, allows her to have pain-free intercourse.

Alice, 34, trans woman

After two years of hormone therapy and a year of hair removal, she has vaginoplasty by skin inversion in a university centre. Dilation takes up a lot of time in the first few months, then becomes less frequent.

Monique, 58

Post-menopausal, she feels discomfort during intercourse that she attributed to laxity. Examination shows mainly dryness; local hormone treatment and a lubricant are enough.

"The vagina stays permanently widened after childbirth"

Not necessarily. The tissues largely recover within the year, especially with rehabilitation.

"Tightening always improves pleasure"

No. It can improve sensation when a defect is real, but excessive narrowing makes intercourse painful.

"Laser replaces surgery"

No. Its effectiveness is debated and it does not correct a muscle injury or a torn perineum.

"Without a vagina, no sex life is possible"

False. Women with MRKH syndrome most often obtain a functional vagina by dilation or surgery.

"After gender-affirming vaginoplasty, there is no more sensation"

False. Clitoroplasty preserves the nerves, and most patients retain erogenous sensation.

"Dilation stops after a few weeks"

No. After gender-affirming vaginoplasty, it becomes less frequent but remains necessary in the long term.

Tightening vaginoplasty can close a gaping vaginal opening, reconstruct a weakened perineum and improve sensation when an anatomical defect is the cause. It does not restore the body as it was before pregnancy, does not resolve low desire or a relationship difficulty, and does not guarantee greater pleasure. Creation of a vagina allows an intimate life, with dilation efforts. Gender-affirming vaginoplasty creates a functional vulva and vagina with preserved sensation, but requires long-term care and sometimes touch-ups.

Bodily changes after pregnancy, the diagnosis of a genital malformation or the gap between body and identity deeply affect self-image. A woman who feels "damaged" after her deliveries, a teenager who wonders whether she is "a real woman", or a trans woman who feels uncomfortable in her body before surgery may experience shame, sadness or isolation. These emotions are legitimate and deserve to be heard.

Surgery can bring real well-being when it meets a specific need, but it is not always the only answer. The caring attitude of professionals, information, contact with others who have lived the same situation and, if needed, psychological support contribute just as much to restoring a calm relationship with one's body. Many women say that it was the whole journey, not just the procedure, that helped them.

Specialist Swiss teams increasingly integrate this dimension, offering psychology, sex therapy and pelvic physiotherapy consultations within a single pathway. Do not hesitate to ask for this support: it is part of care.

Studies on tightening vaginoplasty show improved sensation and sexual satisfaction in most women with a real anatomical defect, with a risk of pain during intercourse that justifies cautious calibration. The data remain of limited quality, and results depend greatly on patient selection and surgeons' experience.

For MRKH syndrome, dilation is effective in the vast majority of well-supported patients, and surgery gives good results when it fails. For gender-affirming vaginoplasty, studies report high satisfaction, improved quality of life and a low regret rate, with complications that are common but mostly minor and treatable.

• It does not treat low desire or relationship difficulties.
• It does not correct prolapse of the bladder or uterus on its own.
• It does not cure stress urinary incontinence.
• It does not replace pelvic floor rehabilitation.
• It does not treat vaginismus or dryness.
• In MRKH syndrome, it does not make it possible to carry a pregnancy.

Keeping these limits in mind allows you to approach the procedure with fair expectations, and to look in parallel for the other responses useful in your situation.

1. Identify your situation

Tightening, creation of a vagina or gender affirmation: each situation has its own pathway.

2. See the right team

Gynaecologist, urogynaecologist or specialist centre depending on the case.

3. Try non-surgical solutions

Rehabilitation, local treatment, dilation, psychological or sexological support.

4. Understand the procedure

Technique, results, risks, recovery, long-term care, coverage.

5. Organise

Timing, help at home, time off work, time for dilation or rehabilitation.

• Does my discomfort persist despite well-conducted rehabilitation?
• Have I completed my plans for pregnancy?
• What exactly do I expect: sensation, comfort, appearance?
• Does the request come from me?
• Am I prepared to avoid intercourse and exertion for two months?
• Have I understood the risk of pain during intercourse?

• Having surgery without having tried pelvic rehabilitation.
• Confusing dryness, vaginismus or prolapse with laxity.
• Aiming for maximum tightening, at the risk of pain.
• Stopping dilation after creation of a vagina or gender-affirming vaginoplasty.
• Resuming intercourse or sport too soon.
• Choosing a laser as the only solution without assessment.
• Neglecting the prevention of constipation after the procedure.

Check the practitioner's specialist title in the federal MedReg register. For tightening, ask how many procedures of this type they perform and how they avoid excessive narrowing. For gender-affirming vaginoplasty, ask about the number of procedures performed by the team, the techniques offered, how follow-up and dilation are organised, and respect for identity throughout the pathway.

A urogynaecologist is a gynaecologist who specialises in pelvic floor disorders: prolapse, urinary incontinence, childbirth after-effects, pelvic pain and laxity. They carry out precise assessments, sometimes with urodynamic tests or perineal ultrasound, and perform reconstructive surgery of the perineum and vagina. For a woman considering tightening after childbirth, they are often the most suitable person, as they can assess all the associated problems and avoid treating a symptom in isolation.

Your GP knows your overall health, treatments and history. They can be the first to hear an intimate complaint, prescribe rehabilitation or local treatment and refer you to the right specialist. After a procedure, they often take over certain care or step in if a problem arises and the centre is far away. Give them the operative report, especially after gender-affirming vaginoplasty, so that they know the technique used and the particular features of follow-up.

They can also coordinate the different professionals — gynaecologist, physiotherapist, psychologist — and make sure no general health question is overlooked during this pathway.

For tightening, gynaecologists, particularly urogynaecologists, have the advantage of knowing the whole pelvic floor, being able to treat prolapse or incontinence at the same time, and integrating rehabilitation into the pathway. Some plastic surgeons also perform these procedures, often combined with cosmetic vulvar procedures. For gender-affirming vaginoplasty, teams frequently combine plastic surgeons, urologists and gynaecologists. The most important thing is to choose a practitioner who regularly performs the planned procedure and takes time for a full assessment.

Do not hesitate to ask the practitioner what proportion of their work is devoted to perineal surgery or gender-affirming surgery, how many patients they follow each year and how they organise follow-up after the procedure. An experienced practitioner will gladly answer and refer you to a colleague if your situation is beyond their field.

First contact

When booking, you can state the reason for the consultation, your chosen first name and whether you would prefer to be seen by a female doctor where possible.

Listening

The doctor asks what bothers you or what you would like, your medical and obstetric history, your treatments and your expectations.

The examination

The gynaecological examination is explained and carried out with your consent, at your pace. It can be stopped at any time.

Further tests

Perineal ultrasound, urinary assessment, imaging in MRKH syndrome, pre-operative assessment for gender affirmation.

The plan

The doctor presents the options, including non-surgical ones, the expected results, risks and recovery, then provides a quote or prepares a coverage request.

Tightening and perineoplasty are performed in a clinic or hospital with an operating theatre and suitable anaesthesia. Gender-affirming vaginoplasty or laparoscopic creation of a vagina require a specialist team, a hospital stay of several days and structured follow-up, with nurses trained in dilation. Check the cantonal authorisation, the team's experience, emergency arrangements and, for gender affirmation, the facility's experience in welcoming trans people with respect for their identity.

• How many vaginoplasties of this type do you perform each year?
• Which technique do you propose in my situation, and why?
• What results can I expect for sensation and intimate life?
• How do you avoid excessive or insufficient narrowing?
• How long are the hospital stay and recovery?
• What dilation or rehabilitation will be needed afterwards?
• What are the most common complications in your practice?
• Can the procedure be covered by insurance?

• How many gender-affirming vaginoplasties do you perform each year?
• Which techniques do you offer, and which do you recommend for me?
• What depth can I hope for with the amount of skin I have?
• How is dilation follow-up organised after discharge?
• Is pelvic physiotherapy planned before and after?
• What is your rate of complications and touch-ups?
• What should I do about my hormone therapy before the procedure?
• How does the coverage request to my insurer work?

A second opinion is particularly useful if you are offered tightening without rehabilitation being mentioned, if you are offered a laser as the only solution, or if you are hesitating between several gender-affirming vaginoplasty techniques. For MRKH syndrome, consulting a second specialist team before surgery can also be reassuring. Bring your reports and test results; they can generally be reused.

Before any vaginoplasty, you sign a document describing the technique, alternatives, risks and care after the procedure. For tightening, it notably mentions the risk of pain during intercourse and the possibility of an insufficient result. For gender-affirming vaginoplasty, it details dilation, possible complications and the permanent loss of fertility. Read it at home, ask all your questions and check that your chosen first name appears on it if you wish.

Smoking

Stopping completely for several weeks before and after is strongly recommended; it reduces the risk of healing complications and thrombosis.

Hormones

For gender affirmation, the team will tell you whether to pause oestrogen therapy temporarily around the procedure; do not change anything without advice.

Bowels

Bowel preparation may be required. Plan fibre and good hydration to avoid constipation after the procedure.

Infections

Any urinary or vaginal infection must be treated before the procedure.

Organisation

Arrange help at home for the first few days, pads, a cushion for sitting and, for gender affirmation, the space and time needed for dilation.

Diabetes, an inflammatory disease, corticosteroid treatment or a skin disease such as lichen sclerosus can slow healing and increase the risk of infection or narrowing. Before vaginoplasty, the doctor makes sure these diseases are under control, adapts preparation and follow-up, and may prescribe local treatment beforehand. An untreated vulvar skin disease can on its own explain pain or discomfort and must be treated before any surgery.

Report all your medicines, including supplements. Anticoagulants and some anti-inflammatories increase the risk of bleeding; how to manage them is decided with the prescribing doctor. Long-term corticosteroids slow healing. Oestrogens — whether contraception, menopause treatment or gender-affirming hormone therapy — increase the risk of thrombosis and may be temporarily adjusted. Never change a treatment without medical advice.

• Written response from the insurer if coverage has been requested.
• Informed consent read and signed.
• Smoking stopped, infections treated.
• Instructions on hormones and other medicines known.
• Bowel preparation if prescribed.
• Pads, cushion, loose clothing.
• Help arranged for the first few days.
• Dilators and lubricant ready if needed.

For tightening, choose a period when you can avoid exertion, lifting and intercourse for six to eight weeks, which can be tricky with young children: arrange help. For gender-affirming vaginoplasty, allow at least two months of availability, because of the hospital stay, fatigue and time spent on dilation. Summer months, with the heat and the temptation to swim, are often less comfortable.

Vaginal tightening and perineoplasty are performed under spinal anaesthesia, which numbs the lower half of the body, or general anaesthesia. Laparoscopic creation of a vagina and gender-affirming vaginoplasty are performed under general anaesthesia. The anaesthetist assesses the risk of thrombosis with you and sets up suitable prevention.

Pelvic procedures, immobility in the first few days and, in trans women, oestrogens increase the risk of a clot in the leg veins. Prevention combines getting up early as soon as the procedure allows, compression stockings or devices, often anticoagulant injections for a few days or weeks, and good hydration. Pain or swelling in a calf, unusual breathlessness or chest pain mean you must call 144 immediately.

You are welcomed in the morning, having fasted. The team checks your identity, using your chosen first name if you have given it. The surgeon reviews the plan with you. After anaesthesia, the procedure takes from an hour for simple tightening to several hours for gender affirmation. On waking, a vaginal pack and sometimes a urinary catheter are in place. Depending on the procedure, you go home the same day or the next, or stay in hospital for several days.

Washing

Rinse with lukewarm water after each visit to the toilet, pat dry, use mild soap. No baths, swimming pools or saunas for several weeks.

Sitting

Uncomfortable in the first few days; a ring cushion and regular breaks help.

Bowels

Avoid straining on the toilet: fibre, water, a gentle laxative if prescribed.

Lifting

No heavy lifting or intense exertion for six weeks.

Pads

Pads only; no tampons or menstrual cups before the doctor approves.

Once healing is complete, intimate hygiene becomes simple again. The vagina cleans itself: external washing with water or a mild, unscented product is enough. Vaginal douches, harsh soaps and perfumed wipes upset the flora and encourage irritation. Cotton underwear, changing quickly out of a wet swimsuit and drying carefully limit thrush. Local hormone treatment after menopause helps keep the mucosa healthy.

After tightening, living alone is possible if someone takes you home and can drop in during the first few days. Prepare simple meals, pads, a cushion and your medicines. After gender-affirming vaginoplasty, fatigue, dilation and care make daily help very valuable during the first few weeks; some patients stay with someone close or in accommodation near the centre.

In the first few days, help with meals, children, shopping and travel is invaluable. Those close to you should know that you must not lift anything heavy, that constipation must be avoided, and which signs should prompt a call to the team: fever, increasing pain, heavy bleeding, difficulty urinating. After gender-affirming vaginoplasty, emotional support also matters: fatigue and repeated dilation can weigh on morale, and a kind presence helps get through this period.

Partners often have questions: how to support a woman considering vaginoplasty, how long the period without intercourse will last, whether sensations will be different and how to approach resuming. Attending a consultation, with the patient's agreement, allows direct answers. It is important for the partner to understand that the decision belongs to the woman, that recovery requires patience and that a return to intimacy can involve other forms of tenderness for several weeks. After gender-affirming vaginoplasty, the partner can also be involved in gradually discovering sensations.

After tightening, one to two weeks off is often enough for office work, longer for a physical job or one that requires long periods of standing. After gender-affirming vaginoplasty, six to eight weeks are usual, because of the hospital stay, fatigue and time spent on dilation. After laparoscopic creation of a vagina, two to four weeks. The sick note does not mention the nature of the procedure.

The very frequent dilation of the first few months can complicate the return to work. It is useful to plan time off accordingly, then return when the schedule allows sessions in the morning and evening, or even at lunchtime if you have a suitable place. Working from home makes this period easier. Your employer does not need to know the nature of the procedure; if you want an adjustment, a general description is enough.

Day 0

One-and-a-half-hour procedure under spinal anaesthesia. Vaginal pack removed in the evening. Home the next morning.

Days 2 to 5

Vulvar swelling, sitting difficult. Ring cushion, cold, gentle laxative.

Week 2

Pain much reduced. Light discharge. Daily walks.

Week 3

Back to office work part-time.

Week 7

Check-up: fully healed. Gradual return to intercourse, with lubricant.

Month 4

No more discomfort. The vaginal opening is closed and sensations are better.

Day 0

Four-hour procedure under general anaesthesia. Waking with a urinary catheter and a compression dressing.

Days 1 to 5

Bed rest, thrombosis prevention, significant swelling. Effective painkillers.

Day 6

Dressing, pack and catheter removed. First dilation guided by the nurse.

Day 8

Discharge, with a dilation and care schedule.

Weeks 2 to 6

Dilation three to four times a day. Significant fatigue, lots of rest.

Month 3

Dilation twice a day. Check-up: good depth, small area of granulation tissue treated at the practice.

Month 6

Intercourse resumed. Sensation present in the clitoris.

Month 0

After several sessions with the gynaecologist and psychologist, Léa decides to start. The physiotherapist shows her how to use the first dilator.

Month 1

Two sessions a day, of twenty minutes. The first are uncomfortable, then easier. She notes her progress in a notebook.

Month 3

Moving to the next dilator size. A difficult session discourages her; the physiotherapist adjusts the position and relaxation exercises.

Month 5

The depth reached is sufficient for intercourse. She meets another young woman affected, which reassures her.

Month 8

First intercourse, with apprehension but without pain. Dilation becomes less frequent.

One year

The vagina is stable. She keeps a dilator for periods without intercourse.

• Is healing progressing normally?
• Are the discharge and pain I feel usual at this stage?
• When can I resume intercourse, sport, cycling and baths?
• Is my dilation sufficient and correctly done?
• Should I start or continue rehabilitation?
• Should a touch-up be considered, and when?

After tightening, judge the result after three to six months, once the tissues have softened, by going back to the initial goals: is the vaginal opening closed, are sensations during intercourse better, has the everyday discomfort gone? After gender-affirming vaginoplasty, the cosmetic and functional result is better judged after six to twelve months. Talk about your impressions at check-ups: persistent discomfort often has a solution.

Coverage depends on the type of vaginoplasty. Compulsory health insurance reimburses treatment of a disease, a malformation or their consequences, when it is effective, appropriate and economical. Tightening requested for reasons of sexual comfort, without a documented injury, is generally considered cosmetic.

For any situation where coverage is uncertain, ask the doctor to send a cost approval request to your insurer and wait for the written response before setting the date. If refused for gender affirmation, an objection and then an appeal are possible; associations can support you.

Tightening and perineoplasty are available in most cantons, in gynaecology departments and clinics. Creation of a vagina and gender-affirming vaginoplasty are concentrated in university centres and a few specialised clinics.

Geneva

University gynaecology department with urogynaecology, adolescent gynaecology and a consultation for trans people; private clinics for tightening. Reference point for prices.

Vaud

Lausanne brings together a university centre and private clinics; the regional hospitals of La Côte, the Riviera and northern Vaud handle rehabilitation and perineoplasty.

Neuchâtel and Jura

Gynaecology and urogynaecology locally for the perineum; specialised procedures take place in Lausanne, Bern or Basel.

Fribourg

Bilingual gynaecology department and pelvic physiotherapists; Bern and Lausanne for complex cases.

Valais

Hospitals in Sion, Martigny, Monthey and Visp for perineal surgery; Lausanne or Bern for creation of a vagina and gender affirmation.

Bern

University centre with urogynaecology and reconstructive surgery; Biel/Bienne for bilingual consultations.

Basel

University centre renowned for gynaecology and variations of sex development, accessible from Jura and Aargau.

Zurich

The widest provision in German-speaking Switzerland, with several gender-affirming surgery and urogynaecology teams.

Central and eastern Switzerland

Lucerne and St. Gallen have full urogynaecology departments; Zurich or Basel for highly specialised procedures.

Graubünden and Ticino

Chur, Lugano and Bellinzona treat perineal problems; Zurich for specialised cases. Consultations in Italian in Ticino.

This comparison shows, for 40 cities, access to vaginal tightening and perineoplasty, access to specialised procedures, and the observed price difference with Geneva for non-reimbursed procedures. For gender-affirming vaginoplasty or creation of a vagina, the team's experience matters far more than proximity.

Medical confidentiality covers your whole pathway. The sick note does not mention the nature of the procedure, and invoices are sent to the patient. A young adult still insured by her parents can ask her insurer to send documents to her own address.

In French-speaking Switzerland, consultations are in French. In German-speaking centres, many doctors see patients in French or English; mention it when booking. Professional interpreters can be requested in hospitals, including for women who speak none of the national languages.

For gender-affirming vaginoplasty or creation of a vagina, the team's experience matters more than distance, and many patients have surgery in another canton. Organise the journey home, accompanied if possible, and a stay nearby for the first few days after discharge if the journey is long. Ask which check-ups your usual gynaecologist can carry out, and identify an emergency department near home. Keep the operative report and instructions with you.

For non-reimbursed procedures, we express prices as relative indices, which are more meaningful than amounts that vary from one facility to another.

Gender-affirming vaginoplasty and creation of a vagina are generally covered by insurance when the criteria are met; their cost is therefore not shown here. Details by city are on our page on vaginoplasty prices in Switzerland.

For non-reimbursed tightening, a deposit is often requested at booking, expressed as a percentage of the quote. Ask about the conditions for postponement in the event of infection, heavy periods or another medical problem, and about cancellation conditions. Ask for them in writing. For a covered procedure, make sure you have received your insurer's written approval before the date.

Colporrhaphy: Suturing of the vaginal wall to strengthen or tighten it.

Perineoplasty: Reconstruction of the perineum between the vagina and anus.

Rectocele: Bulging of the rectum into the back wall of the vagina.

Levator muscles: Pelvic floor muscles that surround the vagina.

MRKH syndrome: Congenital absence of the uterus and vagina, with normal ovaries.

Dilator: A smooth rod of increasing size used to create or maintain a vagina.

Skin inversion: A gender-affirming vaginoplasty technique using penile skin.

Clitoroplasty: Creation of a sensitive clitoris during gender-affirming vaginoplasty.

Granulation tissue: A bud of healing tissue that bleeds easily.

• The word vaginoplasty covers three very different procedures.
• For laxity after childbirth, rehabilitation is always the first step.
• Excessive tightening is the main cause of pain after the procedure.
• In MRKH syndrome, dilation is the first-line treatment.
• Gender-affirming vaginoplasty requires long-term dilation.
• Vaginal lasers have debated effectiveness.
• Insurance coverage depends on the medical situation.

Medespoir Suisse helps you identify the team suited to your situation — gynaecologist, urogynaecologist or specialist centre — in your region and language, prepare your questions and understand what insurance may cover. We respect your chosen first name and the confidentiality of our exchanges.

Whether it is a matter of regaining comfort after childbirth, creating a vagina after the diagnosis of a malformation, or bringing your body into line with your identity, vaginoplasty touches on intimacy and requires a respectful approach, honest information and experienced teams. Non-surgical solutions often have their place, and surgery, when indicated, gives good results if well prepared and followed up. For the budget, see our page on vaginoplasty prices in Switzerland.

Budget

Price differences between cities and cantons, the quote breakdown and ways to save are detailed on our page Vaginoplasty: prices in Switzerland.

Related procedures

• Penoplasty in Switzerland

Our guides

• Guide to intimate surgery for men and women in Switzerland
• Cosmetic surgery in Switzerland

Answers to the most frequent questions about vaginoplasty in Switzerland.

Understanding vaginoplasty

What is a vaginoplasty? It is a procedure that modifies or creates the vagina. The term refers to three situations: tightening of the vagina and reconstruction of the perineum after childbirth, creation of a vagina in a woman born without one, and gender-affirming genital surgery in trans women.

What is the difference between vaginoplasty and perineoplasty? Tightening vaginoplasty acts on the wall and diameter of the vagina; perineoplasty reconstructs the perineum, between the vaginal opening and the anus. The two procedures are often combined, as it is frequently the vaginal opening and perineum that have been stretched or torn during childbirth.

Does the vagina widen permanently after childbirth? It is very elastic and largely recovers in the following months. In some women, especially after difficult or multiple deliveries, stretched muscles or an injury persist. Rehabilitation often improves the situation considerably before surgery is considered.

Which symptoms may justify a consultation? A feeling that the vagina is too wide, reduced sensation during intercourse, air entering and leaving with a noise, a tampon that does not stay in place, discomfort at a scar, a sensation of a lump or heaviness, or urinary leakage.

Does vaginoplasty improve pleasure? It can improve sensation when a real anatomical defect is corrected. It does not act on desire, arousal or relationship difficulties. Excessive tightening can, on the contrary, make intercourse painful. Expectations must be discussed with the surgeon.

What is a rectocele? It is a bulging of the rectum into the back wall of the vagina, due to weakening of the partition between the two. It can cause a sensation of a lump, difficulty emptying the bowels or discomfort during intercourse. It is often corrected during a posterior colporrhaphy.

Does vaginoplasty concern post-menopausal women? It is possible, but at menopause the discomfort often comes from dryness and thinning of the tissues rather than true widening. Local hormone treatment, moisturisers and rehabilitation are often enough. If surgery is carried out, it takes the fragility of the tissues into account.

Should vaginoplasty and labiaplasty be done together? It is possible when there is both laxity of the vaginal opening and discomfort linked to the labia minora. Combining the two procedures avoids a second anaesthetic, but lengthens recovery. The surgeon will discuss it with you according to your needs.

Laxity and rehabilitation

How long should I wait after childbirth? Generally at least six to twelve months after the last delivery, and often after breastfeeding has ended, which temporarily makes the tissues thinner and drier. This interval allows the tissues to recover and rehabilitation to take effect.

Can rehabilitation avoid surgery? Yes, in many cases. Well-conducted pelvic floor rehabilitation strengthens the muscles around the vagina, improves sensation and treats associated urinary leakage. Surgery is discussed when discomfort persists and an anatomical defect is identified.

How many rehabilitation sessions are needed? A course usually includes nine sessions on prescription, renewable as needed. Progress builds over a few months, with daily exercises at home. A physiotherapist specialising in pelvic rehabilitation adapts the programme.

How can I tell whether a muscle was injured during childbirth? Clinical examination, assessing contraction of the muscles around the vagina, and sometimes a perineal ultrasound can identify detachment of a levator muscle. This information helps predict what rehabilitation and surgery can achieve.

Are vaginal cones or balls useful? They can complement rehabilitation by helping to work on muscle contraction, on a physiotherapist's advice. Used alone, without prior training, they are less effective and may be used incorrectly.

Are vaginal lasers effective against laxity? Evidence remains limited and contradictory. Health authorities have warned against unproven promises and reported side effects. These treatments are not reimbursed and do not correct a muscle injury or a torn perineum.

Are vaginal hyaluronic acid injections of any use? They are offered for dryness or to add volume to certain areas, with variable and temporary results. Their usefulness for laxity has not been demonstrated. Ask what data support their use before committing.

Tightening: the procedure

How is vaginal tightening carried out? Under spinal or general anaesthesia, the surgeon makes an incision in the back wall of the vagina, strengthens the supporting tissue, removes any excess mucosa, may bring the muscles together, then reconstructs the perineum. The procedure takes one to two hours.

Do I need to stay in hospital? Most often, you go home the same day or the next day. A vaginal pack and sometimes a urinary catheter are left in place for a few hours. If other procedures are combined, such as prolapse repair, the hospital stay may be slightly longer.

Does the procedure leave visible scars? The scars are inside the vagina and on the perineum, between the vagina and anus. They are discreet and, once healed, barely visible. The perineal scar may remain tender for a few months.

Do the stitches need removing? No, they are dissolvable and disappear within two to six weeks. Small pieces of thread may appear in the discharge; this is normal.

How does the surgeon avoid excessive narrowing? They calibrate the diameter during the procedure, often using their fingers or an instrument, and use bringing the muscles together cautiously, as it is the main cause of pain. Discussing your expectations before the procedure helps them find the right balance.

Can I choose the anaesthesia? To some extent, yes. Spinal and general anaesthesia are both possible for tightening. The anaesthetist advises you according to your health, preferences and the planned procedures.

Tightening: recovery

Is recovery painful? Pain is moderate and decreases considerably after a few days. Sitting is the most uncomfortable at first. Painkillers, cold through a cloth and a ring cushion bring relief.

When can I resume intercourse? After six to eight weeks, once healing has been checked by the surgeon. First intercourse should be gentle, with a lubricant. A feeling of tightness is common at first and eases over time.

When can I return to work? After one to two weeks for office work, longer for a physical job or one that requires standing for long periods or lifting.

Can I use tampons after the procedure? Not before the surgeon approves, generally six to eight weeks. Use sanitary pads in the meantime, including during periods.

How can constipation be avoided? Drink enough, eat fibre, walk and take a gentle laxative if the doctor prescribes one. It is important not to strain hard on the toilet during healing.

Is discharge after the procedure normal? Yes. Slightly bloodstained, then yellowish, discharge is normal for two to four weeks while the stitches dissolve. Foul-smelling or heavy discharge, or discharge accompanied by fever, requires consultation.

Is rehabilitation useful after the procedure? It is often advised a few weeks afterwards, to consolidate the result, restore good muscle coordination and prevent pain during intercourse.

What are the main risks of tightening? Pain during intercourse if the vagina is too tight, haematoma, infection, partial wound breakdown, insufficient result and, exceptionally, a fistula between the rectum and vagina.

What should I do if intercourse is painful after the procedure? Talk to the surgeon. Often the pain decreases over time with physiotherapy, scar massage and dilators. If it persists, minor revision surgery can be considered.

Can I give birth after tightening? Yes. Vaginal delivery remains possible, but it may alter the result. The mode of delivery is discussed with the obstetrician, taking into account the procedure and your wishes.

MRKH syndrome and creation of a vagina

What is MRKH syndrome? It is a congenital malformation in which the uterus is absent and the vagina absent or very short, while the ovaries function normally. It affects around one in four to five thousand female births and is generally discovered in adolescence, because of the absence of periods.

Are women with MRKH syndrome women like any others? Yes. They have female chromosomes, ovaries that produce hormones, a normal puberty and a normal vulva. Only the uterus and part of the vagina are missing. This point is important for identity and self-esteem.

How is a vagina created without surgery? By progressive dilation: gentle, repeated pressure with dilators of increasing size gradually deepens the small depression at the vaginal opening. With specialist support, this method succeeds in the vast majority of patients within a few months.

How long does dilation take? Generally several months, with daily sessions totalling a few dozen minutes. The duration varies with each patient, her regularity and initial anatomy. Follow-up by a specialist team helps progress.

When is surgery offered? When dilation does not give a sufficient result despite good support, or when the patient does not wish to or cannot continue it. Several techniques exist, all followed by a period of dilation to maintain the result.

What are the surgical techniques? Laparoscopic traction, which creates the vagina within a few days, techniques using the peritoneum as a lining, skin grafts and the use of a segment of bowel. The choice depends on the anatomy, the team and the patient's preferences.

Can a woman with MRKH syndrome have normal intercourse? Yes. With a vagina obtained by dilation or surgery, the vast majority of women have satisfying intercourse, with desire, pleasure and orgasm. Sex therapy can help approach first intercourse calmly.

Can women with MRKH syndrome have children? It is not possible to carry a pregnancy without a uterus. The ovaries function, but in Switzerland surrogacy is prohibited. Uterus transplantation remains at the research stage. Adoption is another route. Specialist support helps in thinking through these questions.

At what age should treatment begin? There is no urgency. Treatment begins when the young woman feels ready, often in late adolescence or early adulthood. It is preferable to wait until she is motivated and mature enough to commit to dilation.

Are there patient associations? Yes, associations and support groups bring together women with MRKH syndrome and their families. Talking with other women who have received the same diagnosis helps a great deal. The care team can direct you to them.

Is treatment for MRKH syndrome reimbursed? Care linked to this congenital malformation is covered, by disability insurance (AI) in young people under the conditions in force, then by compulsory insurance. Dilators and physiotherapy may also be covered. Your team will help you with the paperwork.

Gender-affirming vaginoplasty

What is gender-affirming vaginoplasty? It is the surgery that creates a vulva and vagina in a trans woman from existing genital tissue. It includes creating the labia, a sensitive clitoris and a vagina, removing the testicles and repositioning the urethra.

Do I need surgery to change my legal gender in Switzerland? No. Since 2022, changing sex and first name in the civil register is done by simple declaration, with no medical requirement. Surgery is a personal decision, independent of this process.

What conditions must be met? Teams generally require an assessment confirming gender dysphoria, hormone therapy for at least twelve months unless contraindicated, permanent hair removal from the area used for the vagina, and good general health. These conditions are also useful for insurance coverage.

Why is hair removal needed before the procedure? Because the skin used to line the vagina has hairs that would continue to grow inside, causing discomfort, secretions and infections. Permanent hair removal by laser or electrolysis, over several months, must be completed before the procedure.

Which technique should I choose? Penile skin inversion remains the reference technique. Techniques using the peritoneum offer more depth, at the cost of a longer procedure. The bowel segment is reserved for certain situations. The surgeon advises you according to your anatomy and wishes.

What is a zero-depth vulvoplasty? It is the creation of a vulva without a vaginal cavity. It suits women who do not want vaginal penetration or for whom full vaginoplasty carries too much risk. Recovery is simpler and there is no dilation.

How long is the hospital stay? Generally six to ten days. The first few days are spent resting with a urinary catheter and vaginal pack, removed around the fifth to seventh day. The team then teaches dilation and care before discharge.

Is dilation needed for life? It is very frequent in the first few months, then gradually less frequent. Regular maintenance remains necessary in the long term to maintain depth and diameter, at a reduced rate, unless regular intercourse is enough.

Is sensation preserved? Yes, in the vast majority of patients. The clitoris is created from part of the glans with its nerves and blood vessels. Sensation takes several months to stabilise, and many women reach orgasm after the procedure.

Is the created vagina lubricated? A skin-lined vagina does not produce significant natural lubrication. A lubricant is needed during intercourse. Techniques using the peritoneum or bowel produce slightly more secretions.

Is the prostate removed? No, it is kept. Its follow-up must continue according to age-related recommendations. It is important to inform doctors of its presence, particularly during urological check-ups.

Should I store sperm before the procedure? If you are considering having a child, sperm storage may be offered, ideally before starting hormone therapy. Vaginoplasty removes the testicles, which makes sperm production permanently impossible.

What are the most common complications? Narrowing of the vagina, granulation tissue that bleeds, urinary stream problems or urinary infections, partial graft loss, and the need for cosmetic touch-ups. A fistula between the rectum and vagina is rare but serious.

Is gender-affirming vaginoplasty reimbursed? Compulsory insurance covers it when the medical criteria are met, following a prior cost approval request accompanied by the required reports. If refused, an objection and an appeal are possible.

Intimate life, couple and health

Should I talk to my partner before consulting? It is not an obligation, but it is often useful. The partner sometimes perceives much less change than the woman herself. Talking together about expectations, then recovery and the weeks without intercourse, makes the process easier.

My partner is pushing me to have surgery: what should I do? Take time to check that the request comes from you. The doctor can see you alone to talk about it. A procedure carried out to meet someone else's expectations rarely brings satisfaction, and couples counselling may be more useful.

Does sensation return quickly after tightening? A feeling of tightness and altered sensitivity are common in the first few months. Sensations return to normal and often improve gradually as the tissues soften. Rehabilitation helps restore good coordination.

Does vaginoplasty change orgasm? Tightening does not touch the clitoris, the main organ of orgasm. It may change vaginal sensations. After gender-affirming vaginoplasty, clitoroplasty preserves the nerves, and many women reach orgasm. Sensations take several months to stabilise.

Is a lubricant needed after the procedure? Yes, first intercourse is more comfortable with a lubricant, whatever the procedure. After gender-affirming vaginoplasty by skin inversion, it remains necessary in the long term, as the vagina produces little natural lubrication.

Can a sex therapist help? Yes. Sex therapy helps resume intimate life after surgery, overcome apprehension about first intercourse, discover new sensations or work on relationship difficulties that surgery does not address.

Are sexually transmitted infections still possible? Yes, after all vaginoplasties. A neovagina can also be affected. The same precautions and screening apply as for any sexually active person.

Should smear tests continue after vaginoplasty? After tightening, cervical cancer screening continues as normal, since the cervix is kept. In MRKH syndrome, there is no cervix. After gender-affirming vaginoplasty, standard cervical screening does not apply, but a regular gynaecological examination remains useful.

Does vaginoplasty affect urinary leakage? Tightening combined with perineoplasty can improve some sensations of air leakage, but it does not treat stress urinary incontinence, which calls for rehabilitation or specific surgery. After gender-affirming vaginoplasty, urinary stream problems are possible at first.

Is the result of tightening permanent? It is lasting, but the tissues continue to change with age, menopause and any further deliveries. Regular rehabilitation, a stable weight and avoiding excessive straining help preserve the result.

Can tightening be done before having children? It is possible but generally not advised, as vaginal delivery can alter the result. It is preferable to wait until you have completed your plans for pregnancy, unless the discomfort is significant.

Does menopause change the result of vaginoplasty? Falling oestrogen makes the tissues thinner and drier, which can change sensations. Local hormone treatment and moisturisers help preserve comfort. These effects concern all women, whether or not they have had surgery.

Can trans women have gynaecological follow-up? Yes, and it is recommended. A gynaecologist familiar with the technique used can examine the neovagina and advise on dilation, infections and sexuality. The prostate, which is kept, falls under usual urological follow-up.

Is intensive sport compatible with the result? Yes, after recovery. For tightening, high-impact sports and very heavy lifting put strain on the pelvic floor; muscle strengthening and good breathing technique help preserve the result.

Can I go on holiday after the procedure? Wait at least until the first check-ups. After gender-affirming vaginoplasty, dilation and care require particular organisation; take your equipment and make sure you can carry them out in good conditions.

Should I inform my GP? Yes, it is useful. They can carry out a first examination if a problem arises and the centre is far away, and incorporate the procedure into your overall follow-up. Give them a copy of the operative report.

Does smoking increase the risks? Yes, considerably: it slows healing, increases the risk of wound breakdown and, with oestrogen, the risk of thrombosis. Stopping completely before and after the procedure is strongly recommended.

Can a touch-up be done? Yes, once the tissues have stabilised, generally after six months to a year. After tightening, a touch-up corrects excessive narrowing or an insufficient result. After gender-affirming vaginoplasty, cosmetic touch-ups of the labia or clitoris are common.

How should I judge the result? By going back to the goals set at the outset: comfort during intercourse, closure of the vaginal opening and no discomfort in daily life. Wait three to six months before judging, until the tissues soften.

Does vaginoplasty leave psychological after-effects? Most often, it improves well-being when the decision has been well prepared. The first few weeks can be emotionally difficult, particularly after gender-affirming vaginoplasty or creation of a vagina. Psychological support is useful if mood remains low.

Is regret common after gender-affirming vaginoplasty? Studies show that regret is rare when the decision has been well prepared with an experienced team. Reported overall satisfaction is high, even when complications or touch-ups occur.

Practical questions

Which pads should I use after the procedure? Sanitary pads, changed often. No tampons or menstrual cups before the team approves. After gender-affirming vaginoplasty, thin pads are useful for discharge linked to dilation and healing.

Can I shower? Yes, generally from the first few days, without a direct jet on the operated area. Baths, swimming pools and saunas wait until healing is complete, generally six to eight weeks.

How can I sit comfortably? A ring cushion, positions with your weight on one buttock and regular breaks bring relief. Prolonged sitting remains uncomfortable for one to two weeks.

Can I drive after the procedure? Not the same day. Afterwards, when sitting and braking are no longer painful, often after one to two weeks following tightening, longer after gender-affirming vaginoplasty.

Can I cycle? Not before six to eight weeks after tightening, and about three months after gender-affirming vaginoplasty, because of saddle pressure on the perineum.

How is dilation carried out? With a clean, lubricated dilator, lying down, inserting it gently along the axis of the vagina without forcing, then holding it in place for the specified time. A physiotherapist or the nursing team teaches you the technique and the depth to reach.

What should I do if dilation becomes difficult? Do not force it. Relaxing the muscles, enough lubricant and a smaller dilator can help. If the difficulty persists, contact the team: early narrowing is easier to treat if addressed promptly.

Should I use vaginal douches? After gender-affirming vaginoplasty, vaginal rinsing is often recommended to remove secretions and lubricant residue. After tightening, it is generally not necessary. Follow your team's instructions.

How many check-ups should I plan for? After tightening, generally a check-up at two weeks and another at six or eight weeks. After gender-affirming vaginoplasty, more frequent check-ups in the first few months, then regular long-term follow-up.

Can I sunbathe or swim in summer? Swimming waits until healing is complete. The sun is not a problem for internal scars, but visible external scars should be protected for several months.

Can I resume masturbation? Gently, with the same timescales as for intercourse, after the team approves. After gender-affirming vaginoplasty, discovering clitoral sensations can begin cautiously a few weeks later, according to instructions.

Should hormones be stopped before gender-affirming vaginoplasty? Some teams ask for a temporary pause in oestrogen to reduce the risk of thrombosis; others continue it with reinforced prevention. Follow the team's instructions, in liaison with your endocrinologist.

Can I have surgery if I am overweight? For tightening, yes, but excess weight increases healing risks and recurrence. For gender-affirming vaginoplasty, some teams set a body mass index limit, as excess weight increases complications.

Whom should I call at night if there is a problem? The on-call number given by the team, saved before the procedure. In the event of heavy bleeding, intense pain, high fever or inability to urinate, go to A&E or call 144.

Prices, insurance and locations

How much does tightening vaginoplasty cost? We express it as relative indices: tightening with perineoplasty serves as base 100; perineoplasty alone is around 55 to 80, and tightening combined with labiaplasty around 130 to 170. Differences between cities are on our prices page.

Is tightening reimbursed? When it is requested for reasons of sexual comfort with no documented injury, it is generally at the patient's expense. Repair of a childbirth injury or a symptomatic rectocele is often covered by basic insurance, after medical assessment.

Is rehabilitation reimbursed? Yes, pelvic physiotherapy prescribed by a doctor is covered by basic insurance, under the usual deductible (franchise) and co-payment (quote-part) rules.

Where can I have tightening vaginoplasty? In the gynaecology and urogynaecology departments of hospitals and in private clinics, found in most cantons. Choose a team that regularly performs these procedures and gives a place to rehabilitation.

Where can I be followed up for MRKH syndrome? In the gynaecology departments of university centres, often within adolescent gynaecology clinics that bring together gynaecologists, physiotherapists and psychologists. Your gynaecologist can refer you there.

Where can gender-affirming vaginoplasty be performed in Switzerland? Mainly in university hospitals with consultations for trans people, and in a few specialised clinics. Find out about the team's experience, the techniques offered and how follow-up is organised.

Can I consult in French in German-speaking Switzerland? In the major German-speaking centres, many doctors see patients in French or English. Mention it when booking; for such a personal procedure, understanding every explanation is essential.

How can I stay discreet? Medical confidentiality protects the whole consultation and procedure. The sick note does not mention the nature of the procedure, and invoices are sent to the patient.

Can Medespoir direct me? Yes. Tell us your situation in a few words and, if you wish, your chosen first name. A gynaecologist or specialist reads your message in complete confidence, then we put you in touch with the right team near you and in your language. Free and without obligation.

Tell us your situation in a few words and, if you wish, your chosen first name. A gynaecologist or specialist will reply in confidence and direct you to the right team. Free of charge and without obligation.