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Problems can occur during or due to the treatment, even though the surgery has been carried out correctly. These problems are called complications. The risk of complications depends on your personal health and the technique used. If you are overweight or smoke, you will have higher risks of complications.

Complications are divided into two groups: early and late complications.


  • (Continued) bleeding: usually occurs immediately after surgery. Depending on the severity, a second operation may be necessary to stop the bleeding and to remove the clots.
  • Infection: due to the fact that the skin has been exposed, bacteria had the chance to crawl into the wound, although surgery has been done in a sterile manner. There is also a risk of infection after surgery and at home. So take good care of yourself and your wounds.
  • Ileus: this means that the bowel is blocked. As a result, passage of bowel contents is no longer possible. Medication may be given to get the bowel movement going. In addition, it is important that you drink enough and try to mobilize.
  • Wound dehiscence: this means suffering from a wound that ruptured along surgical suture. This generally heals by itself, however the healing process will take longer.
  • Wound necrosis: this means that part of the skin tissue dies completely or partially. Wound necrosis can occur when part of the wound is not well-vascularized. If during surgery it appears that the flap is not well-vascularized, the blood flow status will be optimized during that same surgery.
  • Gastrointestinal perforation: penetration of any part of the wall of the gastrointestinal tract may occur. If noticed during surgery, it will be rectified immediately. If noticed at a later point in time, for example when removing the tampon or at the outpatient clinic, we generally wait for a while and advise you to follow a liquid diet. A small hole usually heals spontaneously. If the hole in the rectum causes long-lasting problems you will need to have another surgery.
  • Suture leakage: With colovaginoplasty it is possible that the parts of the intestine that are sewn together do not heal properly and a leakage is caused by the sutures. As a result, the stool ends up in the abdominal cavity. This will rapidly cause abdominal pain and fever in the first 2-3 days after surgery. Urgent surgery is required to fix the leakage. In case of a severe leakage or a hole in the rectum that won’t heal, a temporary colostomy is sometimes necessary. The colostomy can be removed again after a period of at least 3 months


  • Narrowing of the urethra: A narrowing of the exit of the urethra may occur a number of weeks or months after surgery. In some cases, it may lead to difficulties with urinating; the urine stream has become weaker and you need to press harder. This can be resolved by catheterizing yourself during several weeks. In more severe cases an operation is needed to widen the exit of the urethra. This surgery can usually be performed with local anesthesia.
  • Loss of feeling/orgasm: The surgery can lead to nerve damage. Nerves need months to recover. If this recovery does not occur, there is a chance that the (organic) feeling of the clitoris will never return. There is virtually nothing surgical that can be done about this.
  • Scars: These will differ per person, surgical technique and skin type because everyone and every skin type heals in their own way. The healing process of scars of overweight people and people who smoke is less attractive than that of healthy non-smokers (see section: 1.4 smoking and 1.5 healthy weight). It may be possible to correct scars at least one year after surgery.