The 4th edition
The 4th edition is the era of new concept of flap fixation to make to fixation last longer and the appearance of labia minor more defined for a long time. Now we can get rid of the hair along labia minor, inside the critoris and especially hood of critoris. Anyway,the tecnique cause more tissue slough, the technique has been modified for a while until getting better result.
The 5th Edition
We are still unsatisfied about the appearance of critoris. During this time the anatomy of the gland penis was reviewed and the new dissection and setting was deveoped. After 1 month all the cases were oprerated in the new style of critoris because we can get the good setting , good feeling and better aesthetic result. The uretrae is still set with thick flap.
The 6th adition
Even we reduce the spongy tissue around uretrae. In long term follow up, some one still have problem of enlargement of sponge mass aterior to introitus during arousal peroid. So we remove more tissue with the new tecnique to get rid of the mass that obstruct the neovaginal canal.