to-female transition. This issue may be compensated by a scrotal skin flap, with the
drawback of hair growth [1]. In recent studies, Nile tilapia skin was successfully used for the
surgical management of Mayer-Rokitansky-Küster-Hauser syndrome [2, 3] and vaginal
stenosis [4, 5]. This study aims to describe a novel technique for primary vaginoplasty in
male-to-female gender-affirming surgery using Nile tilapia skin as a biocompatible graft to …