followed by glans sculpture, vaginectomy, urethral anastomosis, scrotoplasty and finished with a penile prosthesis implantation. The ideal outcome of this procedure, as described by the World Professional Association for Transgender Health (WPATH), is to provide an aesthetically appealing penis that enables sexual intercourse and sensitivity. Complications do arise from this procedure which may include tissue death, urethral complications, and infection to name a few. Radial Forearm Free Flap (RAFFF) is one of the techniques considered for total phallic construction. Developed and performed in 1984, RAFFF consists of three stages and a complete vaginectomy is the second stage of RAFFF. The preferred technique is ablation vaginectomy with simultaneous scrotoplasty, which will close the labia majora along the midline. Recurrent gynecologic malignancies An anterior pelvic exenteration with total vaginectomy (AETV) is a procedure that removes the urinary system (kidneys, ureters, bladder, urethra) as well as the gynecologic system (ovaries, fallopian tubes, uterus, cervix, vagina) and is used as treatment of recurrent gynecologic cancers. A total pelvic exenteration can also be used as treatment which involves the removal of the rectum in addition to the urinary and gynecologic systems. The decision between the two procedures depends on extent of the cancer. Potential benefits of an AETV over a total pelvic exenteration include reduced risk of intestinal injury. Reversal of vaginoplasty Neovaginectomy has been performed to remove the neovagina following vaginoplasty, for instance in transgender women who experience neovaginal complications or those who choose to detransition. Contraindications The safety of vaginectomy can depend on individual medical conditions and the subsequent risks they pose. For example, for people with diabetes mellitus, potential contraindications for vaginectomy include wound-healing difficulty; for people who prefer to not undergo hormone therapy, potential contraindications include gonad removal (oophorectomy or orchiectomy). Risks/complications Many people who undergo vaginectomy do so for sexual health and intimacy. However, risks of vaginectomy include post-operative sensory issues that range from lack of sensation to excessive sensation, such as hypersensitivity or even pain. To address this, skin grafting is often done with vaginectomy to allow recovery of sexual function. Other risks may involve consequences of the procedure itself. For example, possible injuries include rectal injury (due to the proximity of the structures), development of a fistula (an abnormal connection between two body parts), or, for people who have phalloplasty done in conjunction with vaginectomy, irritation or even erosion of the skin of the phallus. Some of these