**Question:** Most common complication of vaginoplasty is

A. Infection
B. Urinary tract infection
C. Hematoma
D. Vaginal stenosis

**Correct Answer:** D. Vaginal stenosis

**Core Concept:** Vaginoplasty is a surgical procedure to create a vagina in individuals born without a vagina or with a malformed vagina due to congenital abnormalities or trauma. Common complications after vaginoplasty include:

**Why the Correct Answer is Right:** Vaginal stenosis is the most common complication of vaginoplasty. It occurs when the surgical scar tissue contracts and narrows the newly created vagina, reducing its diameter and potentially impairing the patient's ability to have intercourse or deliver a baby vaginally. This can lead to pain, dyspareunia (sexual pain), and infertility in affected individuals.

**Why Each Wrong Option is Incorrect:**

A. Infection: While infection is a potential risk in any surgical procedure, it is not the most common complication of vaginoplasty. The correct answer highlights the specific issue of vaginal stenosis as the primary concern.

B. Urinary tract infection: This complication is more commonly associated with urethral or bladder surgery, not vaginoplasty. The question specifically asks for the most common complication of vaginoplasty, making this option irrelevant.

C. Hematoma: A hematoma is a collection of blood outside of blood vessels. While it can occur in any surgical procedure, it is less relevant to the specific issue of vaginal stenosis and thus not the most common complication of vaginoplasty.

**Clinical Pearl:**

In the post-operative care following vaginoplasty, close monitoring for signs and symptoms of vaginal stenosis, such as pain, dyspareunia, and difficulty passing a finger or dilator, is crucial. Surgical intervention and medication may be required to address vaginal stenosis, depending on the severity of the issue. Early detection and intervention can help improve patient outcomes and quality of life for those undergoing vaginoplasty.