For a study, researchers examined patterns of neovaginal colonization and inflammation and potential influencing variables.

According to PRISMA recommendations, a thorough analysis of the neovaginal microbiota was carried out until October 2021. There were 13 publications with a total of 458 patients included. Neovaginal constructions were most frequently carried out using sigmoid segments, peritoneal grafts, penile and scrotal skin grafts. The neovaginal microflora that was discovered was often polymicrobial and resembled the original tissue.

Nine studies found Lactobacillus: 5 out of 6 for penile skin, 1 out of 3 for sigmoid, 1 out of one for peritoneum, and 2 out of 3 for other graft types, indicating that the neovagina may support Lactobacillus either naturally, via rectal migration, or through oral probiotic supplementation. Nine research revealed a polymicrobial, bacterial vaginosis-like environment. Additionally, the following inflammatory indicators were listed: 2 of 6 for penile skin, 2 of 3, 2 of 3, 0 of 1, and 1 of 3 for other graft types.

There were little data on the neovaginal microbiome’s effects on postsurgical length, oral hormones, dilation, sexual habits, or douching. Surgery results, particularly those related to inflammation, discomfort, and infection, may be improved by comprehending and enhancing the polymicrobial neovaginal milieu. Standardizing tests, developing categorization schemes, and treating neovaginal dysbiosis should be the main areas of future study.