Peritoneal Graft & Vaginoplasty

[MamaBear318]

Hello!  This is my first post!  I am a mom to a 17 year old trans girl and we are starting to look into surgeons.  Right now the short list is Bowers, McGinn and Ting.   My daughter has been on puberty blockers since the start of puberty and estrogen since she was 15.  Because my daughter's puberty was suppressed she has very little material to work with.  I recently heard of a procedure that has been used for cis women born without vaginas that uses a portion of the peritoneal lining in the abdominal cavity to create a vaginal canal.   Dr. Ting of Mt. Sinai and Dr. Bowers may be offering this option.

Does anyone have any experience or information about Dr. Ting and or the peritoneal graft?  Any info you could offer would be greatly appreciated.   Thank you so much!

[Dena]

Welcome to Susan's Place. I am not up to date on all the current surgical procedures however members tend to contact several surgeons with specific questions about their surgery and normally get detailed responses from the surgeons. I haven't seen this procedure discussed on the forum and normally a skin graft is used but there are other options depending on what the surgeon has to work with. I have move the thread to the GCS section of the site were it's more likely to be seen by member more knowledgable about this topic.

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[kelly_aus]

From some quick research, it appears to be a procedure done more commonly on women with missing or partial vaginas, with or without a vulva, complete or otherwise.

Based on the quick reading I did, it appears that results are more than satisfactory, even over the long term. I'm not sure, though, how applicable this surgery is to trans women.

[AnonyMs]

Dr Suporn in Thailand gets excellent results in this situation. He's retiring soon, but is training a couple of surgeons to take over.

[mistyjensen]

Hi Betsy,

I recommend contacting Dr. Ting directly to also inquire about his peritoneal technique. Dr. Ting's email address is at http://www.mountsinai.org/profiles/jess-ting.

[MamaBear318]

Hi Betsy,

I recommend contacting Dr. Ting directly to also inquire about his peritoneal technique. Dr. Ting's email address is at http://www.mountsinai.org/profiles/jess-ting.

Thank you!  We are waiting for to get an appointment with him.  We just met with the nurse practitioner at the Mt. Sinai Center for Transgender Medicine and Surgery.   Dr. Ting is the next step in the process.  I was interested if anyone had heard if there were any other doctors that serve the transgender community that are adding this to their practices.

[MamaBear318]

From some quick research, it appears to be a procedure done more commonly on women with missing or partial vaginas, with or without a vulva, complete or otherwise.

Based on the quick reading I did, it appears that results are more than satisfactory, even over the long term. I'm not sure, though, how applicable this surgery is to trans women.

From what I read it seems like a good option, especially for someone like my daughter who doesn't have much to work with.  Appreciate you input!

[MamaBear318]

Dr Suporn in Thailand gets excellent results in this situation. He's retiring soon, but is training a couple of surgeons to take over.

Thank you. I heard Dr Suporn is easing into retirement and that he is amazing.  I don't think he is using the Peritoneal Graft method, but I heard his results are good as well.

[Dani]

Skin grafts have been used for many years for vaginoplasty for individuals with inadequate penile skin. The donated skin may be full thickness or partial thickness. The skin may usually come from the lower abdomen or upper, inner thigh. There will be a visible scar where the donated skin was.

Sometimes a small section of the colon will be separated from the bowel and used for the vaginoplasty. The colon is reattached to itself to create two separate structures within the abdomen.

Using the peritoneal lining for a GCS vaginoplasty is a relatively new procedure. In the past, the peritoneal lining was used for small repairs of various structures in the abdomen. I do not know of any other surgeons who will do a complete vaginoplasty from peritoneal lining other than Dr. Ting.

When ever a surgeon suggests a graft of any type, they need to specify where the donated material will come from. They also need to specify what are the known long term complications of that procedure.

[reborn]

The peritoneal graft sounds like an experimental surgical technique to me. It may prove effective in the future, but I would not take the risk. Skin grafts are a proven effective technique to achieve a good depth in people like your child. Suporn technique is great, and there are also many other doctors practicing its variation all delivering great results.

[Complete]

My personal opinion is that you should listen to those who have had actual first hand experience with this technique. In theory this sounds great in that peritoneal tissue is like the inside of your mouth and would be far superior to donated tissue from the back, buttock or inner thigh. It is similar to the lining if the colon in that it is moist and avoids the potential side-effects of colonovaginoplasty. I had that procedure roughly 30 years ago and continue to be very pleased  with the results.

[kelly_aus]

The peritoneal graft sounds like an experimental surgical technique to me. It may prove effective in the future, but I would not take the risk. Skin grafts are a proven effective technique to achieve a good depth in people like your child. Suporn technique is great, and there are also many other doctors practicing its variation all delivering great results.

Not experimental at all, just not usually done on trans women, but it is quite common in vaginal agenesis repairs. So I suppose, it being done on a trans woman is somewhat experimental..

[Complete]

As regards the OP; was peritoneal used for the vaginal canal?

[Rachel]

Dr. Bowers team at Mount Sini has done 12 peritoneal graphs ( it is only done at Mount Sini). Dr. Tieg is on her team. She spends 15% of her time at Mt. Sini teaching doctors GCS techniques. She is activating her license in Colorado to teach a doctor GCS techniques. 

The peritoneal procedure is for trans woman that do not have sufficient material for GCS. One advantage is it can transfer moisture through its membrane. Also, the need to dilation is greatly reduced because the lubrication eliminated the vaginal canal tendency to "stick" together and close.

Dr. Tieg is on Dr. Bowers team and do contact him. The waiting list for Dr. Bowers to do the surgery is 4 years.

I just moderated Doctor Bowers presentation at the PTHC in Philly. This is one topic she briefly covered.

I hope this helps and sheds some light on the subject you inquired about, where to go and who to contact.

Dr. Bowers has on her website the 5 doctors she endorses for GCS. She cautions transwoman and showed us why she only endorses 5 doctors for GCS. She showed examples

I went to Dr. McGinn for GCS. I had a very different GCS procedure. I am intersexed and am having my GCS being done over 3 steps. I had no penile tissue. Penile tissue (pink tissue)  is used to go from the citreous to the vaginal canal. It is erectile tissue and when rubbed can produce engorgement and a pleasure response. I did not have penile tissue so I do not have that feature. I have a very good looking area( for lack of better words) between my citreous and vaginal canal. My whole glands penis was left in place. Later I have labiaplasty and my top was closed up and a clitoral hood made. My bottom gets closed up November 20th. This is a different procedure than you inquired about. If interested PM me and I will give you the name of the procedure, which s my last name. If you want I will send you pics. Keep in mind my bottom part of my vagina is not done yet. I can have a clitoral orgasm and well as a prostate orgasm and back of vagina orgasm. usually all three locations are stimulated.

I understand your concern for your daughter. I hope she has a wonderful experience with whomever she goes to. I cherish the memory and how empowering and satisfying it had enabled me to be.

[Complete]

Is this what we were talking about?


http://www.pinknews.co.uk/2017/09/13/transgender-woman-gets-revolutionary-new-vaginal-surgery-she-helped-to-create/

[Rachel]

Yes, Dr. Ting is part of Dr. Bowers team. They have done 12 of that type surgerie as of last Saturday as per Dr. Bowers. She was speaking at the trans health conference in Philly and I was the room monitor.

[Complete]

I think this is great news.l had colonovaginoplasty 35  years ago and it made  a huge difference in my love life.  No more dilation or lube.Now you have all that w/o all the potential side effects.

[HelloKitty]

Is it a peritoneum surgery like that: http://www.beverlyhillsurogyn.com/vaginal-surgical-procedures-beverly-hills/laparoscopic-neovagina/

[MamaBear318]

As regards the OP; was peritoneal used for the vaginal canal?

Yes.  A segment of the peritoneal lining is used to make the vaginal canal.

[MamaBear318]

Is this what we were talking about?


http://www.pinknews.co.uk/2017/09/13/transgender-woman-gets-revolutionary-new-vaginal-surgery-she-helped-to-create/

Yes!  That is it!