It's not really just "cutting a hole". It's more of removing the testes and head of the penis, cutting the penis into 4 long strands, and then inverting the whole thing up inside the body. It's stitched together and then to prevent the now mutilated flesh from closing the gaping wound in the body it is forcefully "dilated" with medical grade dildos. Forever. There is no natural mechanism for cleaning it because it's not a real fucking vagina and because it is made from the external parts of a penis, hair grows inside of the wound/cavity. Whats more, is that I've only gone into light detail. Every adult should see the surgery.