Last updated July 30, 2025
Introduction#
Phallus-preserving vaginoplasty aims to create a vaginal canal while retaining the penis. Some people call this a Salmacian or bigenital goal. Wanting both structures is a complete goal in its own right; you do not have to justify it as a compromise. MoZaic Care's penile-preservation page shows one program's approach and makes clear that depth, available graft tissue, testicle preservation, and external appearance are discussed individually.
What the operation may involve#
The canal needs lining from tissue other than a dismantled penis. MoZaic describes examples using scrotal skin or robot-assisted peritoneal pull-through. Those are program examples, not a promise that every surgeon offers both. The available skin, desired external structures, testicle choice, and your previous surgery shape the plan. Ask the surgeon to draw the exact anatomy they propose and explain which tissue goes where.
MoZaic's current hair-removal map requires permanent removal in specific areas for its technique; it does not say every penile-preservation operation uses the same map. Ask your own program which donor and canal-lining areas need treatment before booking months of appointments.
What to ask about function and recovery#
Preserving the penis is a surgical aim, but erections, ejaculation, sensation, and orgasm cannot be guaranteed. Ask what tissue and nerves will be moved, what may change in urinary and sexual function, and what postoperative dilation is required for the canal. Ask who handles stenosis, wound problems, or a revision if healing does not go as planned. A center's patient photos and selected cases cannot tell you your personal outcome.
Compare the paths#
Conventional vaginoplasty generally uses penile and scrotal tissue to build a vulva and canal; OHSU's guide describes that approach. Vulvoplasty creates external structures without a canal. Phallus-preserving vaginoplasty has a different tissue budget because the penis remains. Compare your priorities for a canal, external appearance, retained anatomy, sensation, dilation, and future revision with each team rather than comparing unsupported average depths or recovery days.
References#
MoZaic Care. (n.d.). Penile preservation vaginoplasty. Retrieved September 26, 2026, from https://www.mozaiccare.net/peritoneal-pull-through-vaginoplast
MoZaic Care. (n.d.). Penile-preservation vaginoplasty: Hair removal guide. Retrieved September 26, 2026, from https://www.mozaiccare.net/_files/ugd/657623_df1ea96537794858b0d2f4c3b9a6cdbc.pdf
Oregon Health & Science University. (n.d.). Vaginoplasty and vulvoplasty. Retrieved September 26, 2026, from https://www.ohsu.edu/transgender-health/vaginoplasty-and-vulvoplasty