BackgroundStenosis of the neovagina is a late postoperative complication of male-to-female sex reassignment surgery when patients do not have frequent sexual intercourse or do not perform vaginal dilation.CaseA 39-year-old male-to-female transsexual who had sex reassignment surgery, in which a segment of sigmoid colon was used for neovagina construction, developed total introital stenosis and subsequent peritonitis caused by bowel perforation of the colon conduit.ConclusionTo avoid stenosis of the neovagina, an inflatable silicon vaginal stent should be used all day for 30 days, then for 3 months overnight or until sexual function is regular.