Non-penile inversion - why is this technique not used in the US?

I'm sorry for not getting back to you sooner. In Thailand, we provide vaginoplasty with many procedures. But we are not sure in the US. We did not have experience in the US.

This is a question from patients that I answer a lot. I don't believe there is only one correct way to perform this surgery. Clearly, surgeons all over the world are having successful outcomes with both methods. Currently, there is no research to support one technique over another. It is surgeon "preference or opinion." I, personally, choose to do the penile inversion method because it causes trauma to fewer areas of the body. With any technique (peritoneal pull through vs penile inversion vs sigmoid), the risks of performing surgery from below (perineal dissection) are required. With a peritoneal pull through technique, you also take the risk of having a complication in the abdomen. Furthermore, early research suggests that over time, peritoneal tissue more closely resembles skin (squamous metaplasia) and is not self moisturizing. For these reasons, we prefer a penile inversion technique. Penile inversion also has the most long term research data.

Penile skin inversion technique is the technique used as standard today. A urethra graft has been added to its current records. So you can achieve better sexual activity.