In the next week my spouse is starting a job with health insurance that actually has GCS coverage! :o :D I'm excited by this. In all my research into peritoneal vaginoplasty I found out that Dr. Gallagher at the IU Hospital in Indianapolis IN, is going to be offering a version of this procedure.
Otherwise I have been looking to PriyaMed in Mumbia as they are they only ones who have worked with surgeons to offer a version of this for transwomen. Now their doctors have created a procedure that does not use any penile inversion. I can only guess that they use the inner scrotal tissues to form the vestibule area and they connect the peritoneal tube to that.
Dr. Gallagher is working with the general surgical dept at the university hospital there and she will still use the penile inversion for the outer entry point of the vaginal canal, attaching the peritoneal tube to that.
While I find the idea of PriyaMed's version sounds very intriguing, having insurance that will cover GCS right here in the US and within a days driving distance from my home is sounding better and better. In the end it may come down to money. :( I will have to see with this insurance, they will pay for "out of network providers" but a percentage. Then there is a $6000 max out of pocket so it comes down to how much will it cost here verses the cost of travel to India and the procedure there (around $15k).
Both providers intend on offering this fully this spring/summer.
I wish you good luck! The best I can offer you is some advice considering I've had the peritoneal method done (As a revision, attached to the previous penile inversion).
Dilatation is way less intense, I do it twice a day seeing as it's been about 2.5 months since my surgery. However, very often it happens that I skip a dilatation, I've even done once a day for almost 4 or so days in a row, I didn't get any tighter at all or felt changes.
It's very wet, expect to need pantyliners, but it's not so wet that you'll need pads, the wetness coming from the peritoneum is a thin liquid, doesn't really smell like much, just smells like "wet" and at times it can have a slightly (extremely slightly) red or yellow hue, this is mostly due to it mixing with some remaining urine or blood.
As I am the very first one to have this done in my country, we have been establishing a protocol with my doctors based on my case. We've concluded that the best kind of dilator for this procedure is silicone, the peritoneum is quite fragile and doesn't require all that much dilatation. It becomes less fragile over time as it begins to morph into something ressembling vaginal tissue, but for those first 3 months, silicone dilators are very comfortable, less risky and dilate you more than enough. Do bring this up with your doc of course!
Mine was done laparoscopically, so I have laparoscopic scars, one in my belly buttons that's invisible, 3 more around it, hidden by panties, they are 1/4 inch incisions.
Anything else you might wanna know, please do hit me up I'd love to share as much info as I can <3
Thanks Anna.
I am FB friends with one of the girls who had the pilot surgery done in Mumbia. She has been very informative on her experience. I like the idea of the way they have done the surgery, no penile inversion. In doing it that way there was none of the need to stretch and cut the skin so much.
I have concerns about the only surgeon here in the US who is offering it. I have only been able to communicate with 2 of her former patients. One is happy with her results, one has had an aweful time with scarring and not being able to get it fixed. This leaves me concerned.
I know there are patients from almost every surgeon who has problems. One lady I know personally has just returned from Montreal and still has the cathider in place. She has had some trouble finding a doctor who will remove it now. There are bad stories from Chicago. The are many, many girls who end up getting revisions just so they can pee correctly.
All of this actually makes me consider traveling to Mumbia more. I have contact with quite a few who have had surgeries there in the past and leave with everything working properly the first time. It's almost as if the surgeons there are more careful than those here in the US.
As an update,
I have been able to hear from 4 more patients of Dr. Gallagher through Facebook. All were happy with their results, doctor, and staff. Seems the patient coordinator that caused issues for some in the past is long gone now. One lady said 2 of her friends are scheduled to have Dr. Gallagher do their GCS later this year.
I know one member here who previously reach out and shared her blog with her extremely negative results and interactions with that practice. Is there anyone else on here with either positive or negative experiences?
Quote from: Anna994 on February 14, 2019, 02:43:10 AM
I wish you good luck! The best I can offer you is some advice considering I've had the peritoneal method done (As a revision, attached to the previous penile inversion).
Dilatation is way less intense, I do it twice a day seeing as it's been about 2.5 months since my surgery. However, very often it happens that I skip a dilatation, I've even done once a day for almost 4 or so days in a row, I didn't get any tighter at all or felt changes.
It's very wet, expect to need pantyliners, but it's not so wet that you'll need pads, the wetness coming from the peritoneum is a thin liquid, doesn't really smell like much, just smells like "wet" and at times it can have a slightly (extremely slightly) red or yellow hue, this is mostly due to it mixing with some remaining urine or blood.
As I am the very first one to have this done in my country, we have been establishing a protocol with my doctors based on my case. We've concluded that the best kind of dilator for this procedure is silicone, the peritoneum is quite fragile and doesn't require all that much dilatation. It becomes less fragile over time as it begins to morph into something ressembling vaginal tissue, but for those first 3 months, silicone dilators are very comfortable, less risky and dilate you more than enough. Do bring this up with your doc of course!
Mine was done laparoscopically, so I have laparoscopic scars, one in my belly buttons that's invisible, 3 more around it, hidden by panties, they are 1/4 inch incisions.
Anything else you might wanna know, please do hit me up I'd love to share as much info as I can <3
Im interested with this kind of revision as I have done penile inversion 5 years ago.
my question is how soon can you have sexual intercourse after the peritoneum revision? Im worried that it is very fragile and being sexually active.
Sadly, I am my doctor's first patient. We're being very careful and waiting for the 6 months mark before sexual activity. I'll deffo update my own topic once it happens with all of the information.
I know a girl on FB who was one of the three to get the pilot surgery in Mumbia with PriyaMed. I think she mentioned it was around the 3 month mark or so. One of their patients let them do a biopsy and at 3-4 months the peritoneal vaginal lining is indistinguishable from cis vaginal lining tissue under a microscope. This was something that earlier studies on cis-girls with Mullerian agenesis had shown as well.
I have been emailing with Dr. Gallagher's PA. Dr. Gallagher is open to discussing doing it without penile inversion so I'm pretty happy hearing that. I hope to have my second WPATH letter next week. Then its up to finding out how well this new insurance is going to be.
Quote from: Anna994 on February 19, 2019, 05:28:11 PM
Sadly, I am my doctor's first patient. We're being very careful and waiting for the 6 months mark before sexual activity. I'll deffo update my own topic once it happens with all of the information.
Anna, did you have to use an estrogen cream vaginally for the first three months?
No, I wasn't instructed to use an estrogen cream ^^
Wow, thanks for all the info!
What was the best way to get in contact with Dr. Gallagher's office? I'm in Hawaii so calling is always hard to arrange. I filled out the form at (https://universitygenderaffirmationsurgery.com/contact) but wasn't sure if there was a more direct route?
I'm actually scheduled for surgery with Dr. Bowers soon (seems like I've been on her wait list for forever now...), but am really intrigued by the peritoneal method.
I haven't seen/heard from many other previous patients who have had this procedure, but it seems like overall feedback has been pretty good!
I guess I'm having second thoughts about the standard surgical procedure and don't want to go through multiple surgeries if I don't need to.
Alright, well please keep us updated!
That online form is the simplest way. That or their generic email askus@universitygenderaffirmationsurgery.com. Emma is the new patient coordinator. She gave me a direct email to send my letters to her.
So at this point I have sent:
my first letter from therapist, masters degree, long term relationship
my hormone therapy letter from my endocrinologist
a copy of my new insurance transgender policy from their web site
a copy of my new insurance card
My second therapist is supposed to send her letter directly
Now I wait to see what they figure out. After verifying insurance coverage they should contact me and let me schedule a consultation appointment. After this happens I will know more.
Best of luck! I am interested in having this procedure done and hope to hear great news about your experience.
@josie76
Thank you for sharing your experience.
I like what I've heard about this procedure; and my sister lives in Indianapolis, which means I will have help if Dr. Gallagher does my surgery. I will be following your progress closely.
Well my second therapist did not directly send the letter but I am meeting with her later today to pick it up. Then I can send it on. I have not heard anything back about my insurance as of yet.
Thank you!!!!!!! For posting this thread. I know multiple grs patients of Dr. Galligar who are pleased. I will be able to be placed on her waiting list this August and had recently seen Dr. Galligar YouTube video discussing the peritoneal vaginoplasty which seems more ideal to a cis vagina. I didn't realize she would be offering this so soon and it makes me so relieved. Also, didn't Jazz Jennings surgeon perform a peritoneal vaginoplasty for her since she lacked tissue?
Quote from: gracefulhat on March 20, 2019, 08:22:48 AM
Thank you!!!!!!! For posting this thread. I know multiple grs patients of Dr. Galligar who are pleased. I will be able to be placed on her waiting list this August and had recently seen Dr. Galligar YouTube video discussing the peritoneal vaginoplasty which seems more ideal to a cis vagina. I didn't realize she would be offering this so soon and it makes me so relieved. Also, didn't Jazz Jennings surgeon perform a peritoneal vaginoplasty for her since she lacked tissue?
So there is a huge misconception about what is a peritoneal vaginoplasty.
Dr. Ting used Peritoneal like tissue from the scrotum to stitch inside of an inverter penile vaginoplasty. Not the same.
A number of doctors will use scrotal skin with this same type of tissue still connected to form the bottom part of a penile inversion as a standard practice. However you still have a length of regular penile skin first. Also neither surgical style does away with internal scar issues when healing.
I know one lady here who had a partial true Peritoneal vaginoplasty some years ago as a revision surgery to correct lost depth done by Dr. Bluebond-Langer.
So what we are really talking about is a true Pull through peritoneal vaginoplasty. This is done with the Peritoneal pouch inside the abdomen. Now Dr. Gallagher's plan was to still use penile inversion with the peritoneal tissues connected inside. This would be like the revision done by Dr. Bluebond-Langer and the Dr. in Serbia.
What we are talking about is a laproscopic Davydov Method vaginoplasty with full exterior reconstruction. This is what has not been done before last year in India. I have found cases published where a PAIS girls had it done where they had "ambiguous genitalia" so a reconstruction but with less than functional male genitals to start with.
I think the theory is fine. It's just getting doctors to actually do this procedure for us that is the issue.
@josie76
Have you been filled in yet on Dr. Gallagher's standard pre-operative requirements? Some surgeons require a lengthy program of electrolysis, for example. I'd like to make sure I complete all her requirements so that I am ready to go as early as possible, once I have the money and, of course, am accepted as a surgical candidate.
Quote from: Ann W on March 20, 2019, 09:45:37 PM
@josie76
Have you been filled in yet on Dr. Gallagher's standard pre-operative requirements? Some surgeons require a lengthy program of electrolysis, for example. I'd like to make sure I complete all her requirements so that I am ready to go as early as possible, once I have the money and, of course, am accepted as a surgical candidate.
So Dr. Gallagher used to require clearing of hair. Now she does not.
I am finally on the schedule for a consultation at the end of the month! I will know more after that.
Quote from: josie76 on April 04, 2019, 06:14:40 AM
So Dr. Gallagher used to require clearing of hair. Now she does not.
She has a YouTube video where she discusses hair removal where she basically says she doesn't recommend it because it doesn't work, not because its not needed.
Also, there's a new patient post on realself with photo's and all. Its not good.
That's the same patient that had such a bad time with her. Awfull for her but she seems like the only one I can find who had such a result. IDK why. She has written her story several places. I can understand why she does, but again she seems to be the only one. Terrible to be stuck in her situation.
I'm in the process of arranging the procedure in India (I live in New Zealand so travel for surgery is a necessity). For me talking to various people and comparing it with penile inversion it seems a no brainer. Just a better surgery all round.
It's quite difficult to find any information on Indian surgeons, even on an Indian forum I looked at. It seems they aspire to go to Thailand.
The procedure krobinson is talking about is PriyaMed's. It is based out of the University hospital in Mumbia and done by urologynocologists trained with Dr. Mahtre's version of the Davydov Method.
I go see Dr. Gallagher this Friday. I will have more information after that consult appointment.
Hopefully good news. Fingers crossed.
Quote from: Anna994 on February 14, 2019, 02:43:10 AM
I wish you good luck! The best I can offer you is some advice considering I've had the peritoneal method done (As a revision, attached to the previous penile inversion).
Dilatation is way less intense, I do it twice a day seeing as it's been about 2.5 months since my surgery. However, very often it happens that I skip a dilatation, I've even done once a day for almost 4 or so days in a row, I didn't get any tighter at all or felt changes.
It's very wet, expect to need pantyliners, but it's not so wet that you'll need pads, the wetness coming from the peritoneum is a thin liquid, doesn't really smell like much, just smells like "wet" and at times it can have a slightly (extremely slightly) red or yellow hue, this is mostly due to it mixing with some remaining urine or blood.
As I am the very first one to have this done in my country, we have been establishing a protocol with my doctors based on my case. We've concluded that the best kind of dilator for this procedure is silicone, the peritoneum is quite fragile and doesn't require all that much dilatation. It becomes less fragile over time as it begins to morph into something ressembling vaginal tissue, but for those first 3 months, silicone dilators are very comfortable, less risky and dilate you more than enough. Do bring this up with your doc of course!
Mine was done laparoscopically, so I have laparoscopic scars, one in my belly buttons that's invisible, 3 more around it, hidden by panties, they are 1/4 inch incisions.
Anything else you might wanna know, please do hit me up I'd love to share as much info as I can <3
This is very good to know. Thank you for posting this. I am having a peritoneal graft done as a revision as well. My surgery is scheduled for next March with Dr. Bluebond-Langner at NYU.
How long ago did you have your original vaginoplasty? Mine was in August of 2017. I had quite a few complications leading to dyspaneuria and stenosis. Pelvic floor physical therapy has helped some. I only dilate about once a week now, but I haven't lost any further size to my vaginal canal.
I hope you continue to post your results.
With kindness,
Terri
Well first I want to say Dr. Gallagher is pretty awesome!
We discussed potential options. Heck she got a pen and paper and we sketched out different possible ways to do the external parts depending on how the internal was done. She was super receptive to my concerns and ideas as I have been studying the medical journals about this for some time.
Now then, her only issue is needing a urologist/gynourologist who will agree to do the Peritoneal pull through method. (Davydov Method). Doctors have a habit of being stuck in their ways. She has been reaching out to several in the IU hospital system. Most have told her the procedure won't work on a male pelvis because it would be deeper and narrower than a female pelvis. One is willing to go to NYU and see how they have done their Peritoneal cap. However, not what I want. A doctor who recently came to the University system may be more receptive to the idea. She will talk with them more.
Things in my favor though, I have researched this thoroughly. I have noted many videos of the procedure on MRKH women. Noted how those with no vaginal introitus would be just like starting with a male at birth patient from the outside perspective. Noted how a MRKH girls rectal-ureathral pouch is identical to a males rectal-vesical pouch as shown in literature review studies. Then my pelvis is female in shape and depth due to my PAIS. Perhaps this will all help with getting the urologist to want to do the procedure. Once they decide they can do it they will see how it can be done to any normal masculine pelvis also.
Waiting to see what happens. In the meantime, they will be going through the process of submitting to my insurance to get things lined up.
Quote from: Maybebaby56 on April 28, 2019, 08:07:35 AM
This is very good to know. Thank you for posting this. I am having a peritoneal graft done as a revision as well. My surgery is scheduled for next March with Dr. Bluebond-Langner at NYU.
How long ago did you have your original vaginoplasty? Mine was in August of 2017. I had quite a few complications leading to dyspaneuria and stenosis. Pelvic floor physical therapy has helped some. I only dilate about once a week now, but I haven't lost any further size to my vaginal canal.
I hope you continue to post your results.
With kindness,
Terri
Hi Terri!
My surgery was October 3rd, my revision 29'th of November, we're waiting 6-9 months until I have intercourse, that's when I intend to update on my results, I've made a separate topic about my surgery as to not crowd Josie's topic, I hope she won't mind!
Glad to hear you had an awesome experience with Dr. Gallagher!
Quote from: Anna994 on April 29, 2019, 06:57:12 PM
Hi Terri!
My surgery was October 3rd, my revision 29'th of November, we're waiting 6-9 months until I have intercourse, that's when I intend to update on my results, I've made a separate topic about my surgery as to not crowd Josie's topic, I hope she won't mind!
Glad to hear you had an awesome experience with Dr. Gallagher!
I don't mind at all. I'm hoping all my research helps Dr. Gallagher to find a urologist who will perform the laparoscopic part so I can move forward.
Terri I hope everything works out for you too!
I got a follow-up from Dr. Gallagher's patient coordinator today. She is meeting with the heads of the University hospital urology department later this month to discuss moving ahead with the Davydov style procedure!
Fantastic news! Good luck, I watched some of her videos on YouTube she truly seems lovely.