Evaluation of the effects of non-ablative radiofrequency on vaginal dilation in a trans woman after sexual reassignment: a case report

Introduction: Sex reassignment surgeries (CRS) are surgical interventions that can be performed aiming at the adequacy of the anatomical sex to the gender that the subject recognizes. These patients can be offered CRS, such as neovaginoplasty, which can present clinical complications, such as stenosis, atrophy, loss of vaginal elasticity and dyspareunia. The conservative approach to treating these disorders is vaginal dilation. Radiofrequency (RF) is a technique indicated for these vaginal tissue changes. Objectives: to describe the non-ablative radiofrequency (RF)-associated vaginal dilatation process regarding its functional outcome in a transgender woman after vaginoplasty. Methods: this is a 31-year-old intersex transgender woman, with skin reassignment surgery and other vaginal correction surgeries. The current complaint was a short vaginal canal and dyspareunia. The patency of the vaginal canal was 2.5 cm wide and 7 cm deep. Intervention The radiofrequency protocol was performed in the extension of the vaginal cavity. Then, the standard protocol of vaginal dilation was performed. The program consisted of 6 radiofrequency sessions lasting 5 minutes at a temperature of 39 degrees, with an interval of 4 weeks. Results: There was progression of vaginal dilation during therapy, with a change from 2.5 to 3.5 cm in diameter (40%) and from 7 to 12 cm (71.4%) in length. As for sexual satisfaction on the EVA-S scale, there was an improvement from 2.5 (dissatisfied) to 7.5 (satisfied). Conclusion: This study suggests that radiofrequency followed by dilation was effective in enlarging the vaginal canal, reducing pain and increasing comfort during penetration.