They can close the hole off and make a fake penis and fake scrotum. Bottom surgery may (but doesn't always) include removing the uterus and/or ovaries.

There are several different surgical techniques: https://www.healthline.com/health/transgender/phalloplasty

Obviously if the ovaries are removed the person is permanently sterile. It's possible to freeze some eggs before removing the ovaries, but a surrogate mother would be needed to carry the baby.