It is generally recommended to have everything internal removed if you are getting a vaginectomy, for the reason that if something were to be wrong internally, with a vaginectomy you've removed the easiest means of access to that internal stuff. If something were wrong, you'd basically have to open up the abdomen whereas before you could just go straight in.
I haven't heard of anyone having urination issues. I know a guy who had a vaginectomy done with his phallo (without urethral lengthening), and he hasn't experienced any changes down there after healing.
You may find some bottom surgeons willing to be flexible about it, while others aren't willing to do it. Off the top of my head, Dr. Crane is a good option to approach, as he's a people pleaser. Dr. Schechter would have to be crossed off the list. But you might also be able to find an OBGYN that will do it.
I am curious about how insurance coverage would work. Mine is covered as a part of my phalloplasty, but I'm not sure I've ever heard someone do it as a standalone procedure.
