A woman has become the first transgender person in the world to undergo successful vaginal reconstructive surgery using the skin of tilapia fish.
The 35-year-old, who prefers to be identified only as Maju, underwent the procedure as her vagina began to shrink and close up following botched sex reassignment surgery.
A medical team led by gynaecologist Professor Leonardo Bezerra, of the Federal University of Ceara (UFC) in Fortaleza, north east Brazil, revealed that the pioneering operation has given her the chance of having a sex life again.
The procedure, called neovaginoplasty, has also vastly improved her self-esteem.
It used a tubular-shaped acrylic mould wrapped with the skin of the freshwater fish in the form of a biological prothesis to rebuild and extend the vaginal canal in a three-hour operation on April 23.
Three weeks after treatment Maju said: "I’m absolutely thrilled with the result.
"For the first time in my life I feel complete and like a real woman."
The process involved inserting two separate molds to create the new vagina.
The first device, mounted with the marine membrane, was incorporated inside the vagina over six days.
In contact with the patient’s body, the sterilised and odour free fish skin reportedly displays stimulatory cell growth properties.
It is rich in type 1 collagen, a substance that promotes healing and has a firmness and elasticity which is as strong and resilient as human skin.
The tilapia membrane attached to and re-coated the walls of the vaginal canal acting like stem cells.
These were absorbed into the body, transforming into cellular tissue similar to that of an actual vagina, reports say.
The second device made from silicone and described as a very ‘big tampon’ is designed to remain inside the vagina for up to six months to prevent the walls from closing.
Professor Bezerra told FocusOn News: "We were able to create a vagina of physiological length, both in thickness and by enlarging it, and the patient has recovered extremely well.
"She is walking around with ease, has no pain and is urinating normally. In a couple months we believe she will be able to have sexual intercourse.”
The device can be removed after this period as and when desired.
The process is being hailed as yet another breakthrough in gynaecological surgery which is tackling sensitive predicaments using the aquatic animal skin, normally thrown away as waste, as a substitute for human regenerative tissue.
Speaking exclusively to FocusOn News the transsexual patient revealed she decided to transition 20 years ago, with the support of her family.
She'd realised in her early teens that she was a woman living in a man’s body.
Maju said: “I was the fourth person in Brazil in 1999 to have, what was then, experimental surgery.
"But ten years ago I developed vaginal stenosis. The opening of my vagina started to get narrower and shorter and the canal collapsed.”
She suffered constant discomfort which prevented sex with her partner of 12 years, from whom she is now divorced.
Resigned to living a celibate life, Maju, who works as a florist, returned home to live with her mother in Sao Paulo.
But then she found out about Bezerra’s unprecedented procedure of creating new vaginas for women affected by the rare congenital vaginal agenesis, Rokitansky syndrome.
Since developing the technique three years ago, Bezzera has successfully treated 10 women and corrected the condition that causes the vagina and uterus to be underdeveloped or absent.
Last year May, FocusOn News exclusively revealed how 23 year-old patient, Jucilene Marinho, became the first woman in April 2017 to have her vaginal canal reconstructed from tilapia fish skin after she was diagnosed in her teens with having no cervix, uterus, ovaries or womb.
According to Bezerra, vaginal tract closure is common in transgender women who have undergone a sex change.
He explained: “This is because, in the traditional procedure, most of the inside parts of the penis are removed and the penile skin is folded into the space between the urethra and the rectum.
"The outside skin of the penis then becomes the inside of the vagina.
"But because the patient has had hormonal treatment to develop female characteristics, there is penile and testicle atrophy resulting in shrinkage in the size of the penis caused from the loss of tissue. This means the vagina can also be small."
To complicate matters, before surgery could begin, the medical team discovered that the original surgery had left more than one narrow vaginal canal.
There were remnants of cavernous bodies, erectile tissue structures, still in the vaginal space.
“The presence of these leftovers of the penis aggravated the closure of the vaginal tract, worsening the symptoms,” said Bezerra.
To reverse this problem, the most common method is reportedly to do a skin graft taken from other parts of the body, usually from the intestines, to increase the width and length of the canal. This type of surgery is invasive, long and leaves scars.
Bezerra said: “The great benefit of our technique is that it’s minimally invasive and there’s no need to do abdominal incisions.”
Research reportedly shows that tilapia skin is disease resistant with little chance of rejection as there is an absence of cross-infection between aquatic animals and humans, unlike with other animals.
Before it can be used, the tilapia skin is subjected to an extensive and rigorous process of sterilisation and irradiation at the Nucleus of Research and Development of Medicines (NPDM) part of the UFC.
The end result is an odour-less light coloured product which is vacuum packed and stored for up to two years in refrigerators at the first tilapia skin bank inaugurated in 2017.
The procedure means the material can be safely distributed to treatment centres across Latin America and exported abroad.