GRS without a vagina- part 2

[clodie]

Having read the previous posts on this subject begun by another user, and noticing that a related query from 2012 (GRS and prostatectomy) had led nowhere, I thought I'd add something to the discussion.

Perhaps this only applies to a small number of us, but another reason for considering a cosmetic,as opposed to functional vaginoplasty is a prior prostatectomy.

It is my understanding that removal of the prostate, as treatment for cancer, also involves surgically cutting away the muscular sphincter of the bladder neck ( the main valve preventing you from weeing yourself). Patients  have to try and learn to use the muscles of the pelvic floor ( which previously only had a supporting role in keeping dry) as their sole means of continence.
The urethra, vagina and rectum all pass through the muscular sling which is the pelvic floor.  I would imagine that, post prostatectomy, creation of a vaginal canal as a new breach in the pelvic floor would lead to incontinence as the pelvic floor muscles have to relax sufficient to allow penetration/dilation
A further issue is that the prostate lies close to the rectum, and scar tissue from any prostatectomy surgery can make fashioning a vagina problematic (this was gleaned from one of the UK SRS surgeons, via a third party).

A further factor to consider is that prostatectomy  means the erogenous prostate has gone, no longer lying adjacent to the neovagina. Possibly then, penetrative vaginal sex  would be less pleasurable.

I'm not a surgeon, just someone who realises that cosmetic vaginoplasty may be an option for me, having had a prostatectomy.

[Jacqueline]

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[Dani]

Clodie,

You are absolutely correct in stating the problem. I had a TURP about a year and a half before my GRS.
And yes, I do have some of the problems you mentioned. I have another friend with a more severe prostate issue.

At Southern Comfort Conference, I talked to Dr. Marcie Bowers about prostate issues before GRS. Dr Bowers seemed confident that she can address these issues. I recommend a consult with Dr Bowers for a more definitive answer to your concerns.

[PrincessCrystal]

HRT already shrinks the prostate, and it's an internal organ.  Why would you want it totally removed?  Also, are you sure you want to walk out of that extensive of a surgery without a functioning vagina?  That's not exactly easy to change your mind about...

[Michelle_P]

HRT already shrinks the prostate, and it's an internal organ.  Why would you want it totally removed?  Also, are you sure you want to walk out of that extensive of a surgery without a functioning vagina?  That's not exactly easy to change your mind about...

Leaving a cancerous prostate in place and hoping for the best from HRT might not be the wisest choice, either.   I was fortunate in that the biopsies for my prostate came back negative for cancer, so rather than the full prostatectomy, which shortens the urethra and lowers the bladder into part of the area needed for vaginoplasty, I got away with a trans-uretheral resection of the prostate (TURP), where most prostate tissue is removed via the urethra, a sort of root-rooter approach.      I was unable to urinate without a catheter.  Running a catheter in and out 6 times a day is NOT fun.

The not-so-good news is that in spite of finasteride and starting HRT, enough prostate tissue regrew to put me back on the catheter until a second TURP could be done to clear out the new growth.  I had lots of bleeding this time.    I really, really hope this doesn't happen again.