GRS Peritoneum

[Valecia_Cho2013]

I've posted on here before about my only being able to get 3 inches due to my having a circumcision when I was 6 (medically necessary). I had prolapsed and due to the shallow nature of my vagina, repacking it wasn't going to work. I was exploring the option of colovagioplasty, so at my last appointment to sort out this prolapse, I made the enquiry. I also asked about using the peritoneum. Since this is the UK, this is an experimental procedure, Mr Thomas who has trained the other surgeons on the NHS, has only done this twice. One was successful. I'm really stuck. How do I make this decision? I do have a good amount of time to work with. I'm 4 months post op and no surgeon is gonna go back in there till I've recovered a full 8 months. Also, due to lack of tissue, my stitches broke down resulting in bilateral necrosis of the labia, resulting in 2 months with a urinal catheter. Survived that and healed up.

I've heard of ppl having colovagioplasty just having horrible results. Bad smelling vaginas, cleansing being nasty, big incision scars like c-sections and coming out looking like they're pregnant. I've read things about the peritoneum technique having the benefits of colo, but without alot of the aforementioned  side effects.

[josie76]

Best suggestion is to research Modified Laproscopic Davydov Method.

This is a pretty old and well known way of making the neovagina for girls with Mullerian agenesis or MKRH syndrome. It has been used for decades. However for transgender women it is just being looked at by most surgeons.

I have been searching for a surgeon who will do this peritoneal method on trans girls. I have also read a lot of published research on it. Now that you have a shallow vaginal canal, I would think you should have an easier time finding a doctor

Dr's Milkos and Moore in the US specialize in the surgery. They work an MKRH and Complete AIS girls. So basically patients for whom they do not have to do any external reconstruction. Like where you are today.
The surgeons at the hospital in Mumbia India are supposed to offer this procedure for trans girls in 2019.
Dr. Gallagher at IU Hospital in Indianapolis IN is supposed to begin offering it soon.
Dr. Whitehead who now runs tye Reed Center in Florida said he has done the surgery in the past, but he does not own his own endoscopic tools where he is now.
There are a lot of surgeons in gynourology who have done the surgery for MKRH girls around the world but particularly India and China and of course Russia where it was developed.

Almost no other SRS surgeon has experience with the peritoneal procedure. That's because most are plastic surgeons first and not practiced at general surgery or laproscopic tools. It's more a urogynocologist area of expertise.

[Complete]

This is definitely the leading/cutting edge of the state of the art. Just like penile inversion was the state of the art in the late 50's, finding a competent practitioner will always be challenge.  Colovaginoplasty has received terrible reviews but,  always from those "who heard" this and that from "somebody" else, maybe even 2nd or 3rd hand,  or...on the internet.
As I have posted numerous times on this forum, l had colovaginoplasty after my marriage to my second husband who was particularly well endowed and after nearly a year of very little sexual activity and virtually no dilating.
Prior to my sexual hiatus,  my original srs was working just fine.
The bottom line is that the colovaginoplasty is far superior to penile inversion. The healing period is much less, required dilation is less, and the ability to have spontaneous, and care free sex is life changing.
For me the downside that l experienced was excessive discharge for about a year, (gradually reduced to zero), and a reduced ability to digest fatty foods. The unpleasant odor was not much worse than the awful smells from the original srs resulting from the dead or dying tissue slouching away.

[AnonyMs]

Colovaginoplasty has received terrible reviews but,  always from those "who heard" this and that from "somebody" else, maybe even 2nd or 3rd hand,  or...on the internet.

For what its worth, I met someone who has a friend with the odor problem.

I suspect that the truth is that there a lot of people who've had problems with this surgery, and many that have not. I don't know why. Perhaps it depends on the surgeon or luck. Unless you can find a surgeon with a really good track record for this, which no one has, I think its a big unknown and hence a risky surgery.

[Valecia_Cho2013]

For what its worth, I met someone who has a friend with the odor problem.

I suspect that the truth is that there a lot of people who've had problems with this surgery, and many that have not. I don't know why. Perhaps it depends on the surgeon or luck. Unless you can find a surgeon with a really good track record for this, which no one has, I think its a big unknown and hence a risky surgery.

Aaaaand this is why I'm going the peritoneum option. There is no removal of a vital organ, but rather a tissue that can always grow back (from what I've read and understand), then trying to reconnect said vital organ. Since colo is using a poop chute, the chance of an infection and horrible smells is very much there, more so.

[Valecia_Cho2013]

Best suggestion is to research Modified Laproscopic Davydov Method.

This is a pretty old and well known way of making the neovagina for girls with Mullerian agenesis or MKRH syndrome. It has been used for decades. However for transgender women it is just being looked at by most surgeons.

I have been searching for a surgeon who will do this peritoneal method on trans girls. I have also read a lot of published research on it. Now that you have a shallow vaginal canal, I would think you should have an easier time finding a doctor

Dr's Milkos and Moore in the US specialize in the surgery. They work an MKRH and Complete AIS girls. So basically patients for whom they do not have to do any external reconstruction. Like where you are today.
The surgeons at the hospital in Mumbia India are supposed to offer this procedure for trans girls in 2019.
Dr. Gallagher at IU Hospital in Indianapolis IN is supposed to begin offering it soon.
Dr. Whitehead who now runs tye Reed Center in Florida said he has done the surgery in the past, but he does not own his own endoscopic tools where he is now.
There are a lot of surgeons in gynourology who have done the surgery for MKRH girls around the world but particularly India and China and of course Russia where it was developed.

Almost no other SRS surgeon has experience with the peritoneal procedure. That's because most are plastic surgeons first and not practiced at general surgery or laproscopic tools. It's more a urogynocologist area of expertise.

Unfortunately, I am based in the UK and all my financial savings... well the part that isn't used for important things like rent, food, toiletries, etc, is going towards FFS and breast augmentation.

[Valecia_Cho2013]

The bottom line is that the colovaginoplasty is far superior to penile inversion. The healing period is much less, required dilation is less, and the ability to have spontaneous, and care free sex is life changing.

I don't think that's the case. From what I understand, for colovaginoplasty, the healing process is very long and arduous. Also, you still need to dilate. Self-lubing is still a benefit. Buuuuut~ as I said previously, peritoneum is just taking bits of tissue, that will grow back, as suppose to parts of a vital organ.

[Valecia_Cho2013]

What I really want at this point is anyone who has had the peritoneum technique done on them and tell me what it was all like. I'm hoping they won't need to really cut into my abdomen. If it's just a keyhole procedure, then great.

[Sydney_NYC]

What I really want at this point is anyone who has had the peritoneum technique done on them and tells me what it was all like. I'm hoping they won't need to really cut into my abdomen. If it's just a keyhole procedure, then great.

I had the peritoneum technique done about a year ago with Dr. Rachel Bluebond-Langner at NYU. Note that when I had my vaginoplasty she only used this method when there is not enough material for a regular inversion method and I was one of the first she used this technique on. Due to my intersex condition, she used the peritoneum technique to give me additional depth. From what I understand she is using this technique more and more but it is in addition to the penile inversion method and doesn't replace it.

She uses a robot to laparoscopically help create and attach the vaginal wall and there were several small incensions on my stomach including one the went through my belly button the robot arms go through. The robot is how she gets the peritoneum tissue to use with the vaginal wall.

I'm more than happy with the result. I have some natural lubrication so I never feel dry. I still need lube for the dilating, but for smaller things, I don't have to but do for comfort. My wife is 46 years old (I just turned 48) and she commented a few weeks ago that I'm moister down there then she is. Now I'm now dilating just once a day and after I see Dr. Bleubond-Langner on Tuesday for my 1-year followup I'll know if to can move to dilate just a few times a week.

I'd like to add to the discussing that the purpose if dilating is stretching the muscle more so than the skin of the vaginal wall. Dilation is important as it takes a while for the muscles there to learn the new positioning of things.

[josie76]

Sydney, do you have a email or contact direct to Dr. Bluebone-Langner's office? A lot of the University Hospitals do not like to forward information requests it seems. They all want you to schedule a consultation in person to ask a question.

What I really want at this point is anyone who has had the peritoneum technique done on them and tell me what it was all like. I'm hoping they won't need to really cut into my abdomen. If it's just a keyhole procedure, then great.

I have done a lot of research on it. You can find videos of the surgeries on YouTube by various doctors, many in India and a couple in the US. It generally uses three small incisions on your abdomin for the laproscopic surgical tools. The surgeon also penetrates the peritoneal lining by your vaginal end so the peritoneal lining can be grabbed and pulled down. Then a suture is used to close the end of the peritoneal vaginal canal and keeps it anchored to the main abdominal pouch. I wonder though, in a revision, the surgeon will need to go and remove the original anchoring suture made for the penile inversion over to the sacral tendon before they can open the blind end and connect to the peritoneal extension.

Another thing I found interesting is that for MKRH girls it was common to use "ileal" grafts which was small intestine. Seems like the SRS surgeons are the ones who came up with using colon intestine instead of small intestine.

[Sydney_NYC]

Sydney, do you have a email or contact direct to Dr. Bluebone-Langner's office? A lot of the University Hospitals do not like to forward information requests it seems. They all want you to schedule a consultation in person to ask a question.

I sent you a PM about this.