found, a more complete vaginectomy is performed to remove all cancerous tumors and cells. Gender affirming surgery In vaginectomy for gender affirming surgeries, the tissue from the vaginal wall is removed while outer labial flaps are sometimes left in place for other reconstructive surgeries. The procedure gives people who were assigned female sex at birth but do not identify as female, such as transmasculine or nonbinary individuals, genitalia that aids in reducing gender dysphoria and affirming their gender identity through their physical appearance. Counseling is often provided to people considering gender affirming surgeries prior to procedures in order to limit regret later down the line. In the context of gender affirming surgery, procedures are categorized as either colpocleisis or total vaginectomy. Colpocleisis only removes a layer of epithelium or the outer most tissue in the vaginal canal. The walls of the vaginal canal are then sutured shut, but a small channel and the perineum area between the vagina and anus is typically left open to allow for discharge to be emitted from the body. A colpoclesis procedure is sometimes preceded by an oophorectomy and or a hysterectomy to remove the ovaries and uterus which reduces risks of complications from leaving these structures intact and reduces the amount of vaginal discharge. If the ovaries and uterus are left in tact there are greater levels of vaginal discharge remain that can contribute to further gender dysphoria in individuals. Total vaginectomy is becoming the more common form of vaginectomy in gender affirming surgeries. It involves removal of the full thickness of vaginal wall tissue and can be approached vaginally, as in a transvaginal or transperineal vaginectomy, or abdominally through the area near the stomach, as in a abdominal vaginectomy. In addition to a greater degree of tissue removal, total vaginectomy also involves a more complete closure of the space in the vaginal canal. In comparison to colpocleisis, it is more often preceded by separate oophorectomy and hysterectomy procedures and proceeded by a separate gender reconstruction surgery such as to create a neophallus. Total vaginectomy surgery is sometimes performed using robotic assistance which allows for increased speed and precision for a procedure with less blood loss and a quicker recovery time. Recovery Individuals should expect to experience some pain in the first week after the operation. The average hospital stay after operation was a week and all individuals are discharged with a catheter, which