A gruesome and compelling video has revealed the great skill and precision involved in carrying out a male to female sex change.

The animation, uploaded by the European Society of Urology , shows how a penis and testicles are used to create a vagina, complete with a clitoris capable of orgasm.

The procedure is irreversible, so as a condition - the patient must be completely certain they want to go through with it.

See the video after the cut. WARNING: Disturbing footage.
MirrorUK reports that patients about to undergo the transformation need to have had two psychological approvals - where experts deem they should have the surgery - before surgeons assess whether they are fit enough for it.

They must also have lived as a woman for at least 18 months, had hormone therapy for 12 months, and changed their first name legally by deed poll.

The video shows how the patient is first placed lying on the operating table flat on their back with their feet turned outwards.

A catheter is placed in their urethra to drain urine and collect the fluid.


Surgeons then make a cut in the scrotum, the flap of skin is pulled back, and both testicles are removed.

Next, the dorsal nerve bundle, which gives the penis feeling, the glans or head and the urethra which carries urine are separated from the main shaft of the penis.

Now, with the patient's legs raised, the shaft or corpora cavernosa is cut away, leaving only the urethra left.

The excess skin of the penis and foreskin is used to make a long flaccid tube of skin, which is inverted to become vaginal canal, known as a ‘neo-meatus’.

The rest of the urethra is stitched into it to make the canal slightly wider in circumference, so the woman will be able to have sex.

Next, incisions are made in the genitals where women normally have a clitoris and a urethra.

A clitoris is formed through cutting the glans, the head of the penis, to a smaller size. It is then attached to the genitals with fine stitches.

Surgeons then cut further down what was the scrotum, towards the anus, and cut away the anus’ main tendon, the centrum tendineum.

The space between the rectum and the base of the prostate is roughly developed to make space for the new vagina, and the area is stitched up.

For the outer female genitals, each half of the skin of the scrotum is tailored to become the labia minora and majora – the inner and outer ‘lips’ of the vagina’.

The incisions are strategically placed to look like natural skin closes in the vaginal lips.

The operation is then finished.

Research has shown that after surgery many patients are able to enjoy a satisfying sex life.

In one study, at the University of Tuebingen, Germany, all 24 patients were able to have an orgasm!!! Watch video below.