Interesting surgical technique requiring less dilation

[Lauren24]

Hi everyone! I'm newer around here. Like many of you on this board, I'm interested in GCS. One thing that personally scares me is the lifelong requirement of dilating. I found an article that suggests a certain type of GCS technique doesn't require dilation for the long term once a person is post op. Here is the article.

https://www.ncbi.nlm.nih.gov/pubmed/29383415

Does anyone know of a surgeon who uses this technique? I couldn't find much online but am really interested in it. Does anyone know or have experience with this sort of thing?

[Chloe]

Lauren no experience but technique sounds promising, had to look this one up:

Amnion seeded with fibroblasts extracted from the patient's own cells will result in a vagina with the proper size and moisture that can eliminate the need for long-term dilatation. The constructed vagina has a two-layer structure and is much more resistant to trauma and laceration. No cases of stenosis or stricture were recorded.

[AnonyMs]

I've seen quite a few advances like this, but nothing seems to actually change in practice.

[SadieBlake]

The senior author of this study practices in Iran and uses amnion (placental lining) grafts for vaginoplasty, the harvesting and cultivation of autologous fibroblasts seems to improve patency. I wasn't especially impressed with the aesthetics I saw in the paper, and IAC doubt any western surgeons will be trying this out.

Interesting work, placental grafts aren't a new thing, I don't know how widely they're used.

[AnonyMs]

I don't care for the aesthetics either. Some of the scarring may be due to the patient being Middle Eastern, as I believe they are more prone to it.

Out of curiosity I've tried to find out more about SRS in Iran in the past and never had much luck. I never thought of looking at papers.

I wonder how many surgeries are done in Iran? They have only done 24 surgeries in total "Over 8 years, 24 patients underwent male-to-female sex reassignment surgery in our clinic."

The peritoneal method has been getting some attention since Jess Ting did that piece in Wired Magazine. The paper mentions using the peritoneum - The peritoneum and omentum are not commonly used in the reconstruction of neo-vaginas. The disadvantages of using peritoneum are several...

https://www.wired.com/story/a-patient-gets-the-new-transgender-surgery-she-helped-invent/

[Lauren24]

The senior author of this study practices in Iran and uses amnion (placental lining) grafts for vaginoplasty, the harvesting and cultivation of autologous fibroblasts seems to improve patency. I wasn't especially impressed with the aesthetics I saw in the paper, and IAC doubt any western surgeons will be trying this out.

Interesting work, placental grafts aren't a new thing, I don't know how widely they're used.

I didn't realize that's where the author practices. One thing about Iran is that they can be ahead of the curve sometimes, and behind it other times. Sometimes there are combinations. Like in a regressive attempt to curb homosexuality, they have turned to GCS and forced it on homosexuals. Interestingly this makes it potentially easier for transsexuals to transition in Iranian society, although social rejection is also common there from what I have heard.

They could be onto something but this is also a small sample size. I feel like it has likely been scrutinized and reviewed though, as I originally found the study on Atena's clinical policy bulletin on transsexuality.

http://www.aetna.com/cpb/medical/data/600_699/0615.html

[warlockmaker]

In Iran being gay is punishible by stoning and the Ayotoulla Kohmini changed the law and allowed gays to undergo GRS to become females some 20 years. Quite an interesting story, just google it. They were the country with the 2nd most GRS, after Thailand. I am sure they have some interesting surgery techniques.

Dialation frequency and duration varies with surgeons in Thailand. We have Dr Chett requiring 3x daily for 30 mins to PAI requiring 2x a day of 15 minutes. 90 minutes versus 30 mins is a big difference in time. I am a PAI girl and the dilation of 2x  for 15 mins worked really well. I still have the 6 inch depth and now after almost 3 years only dilate 4 to 5 times a week for 20 mins.

[Lauren24]

I don't care for the aesthetics either. Some of the scarring may be due to the patient being Middle Eastern, as I believe they are more prone to it.

Out of curiosity I've tried to find out more about SRS in Iran in the past and never had much luck. I never thought of looking at papers.

I wonder how many surgeries are done in Iran? They have only done 24 surgeries in total "Over 8 years, 24 patients underwent male-to-female sex reassignment surgery in our clinic."

The peritoneal method has been getting some attention since Jess Ting did that piece in Wired Magazine. The paper mentions using the peritoneum - The peritoneum and omentum are not commonly used in the reconstruction of neo-vaginas. The disadvantages of using peritoneum are several...

https://www.wired.com/story/a-patient-gets-the-new-transgender-surgery-she-helped-invent/

It's my understanding that Iran performs some of the most GCS of any country, mostly due to their seeing it as a cure for homosexuality.

https://fanack.com/iran/human-rights/gender-reassignment-in-iran/

By the way, I'm very interested in Dr. Ting's work. I have yet to find any real review of it, yet you had a piece in there seeming to list the disadvantages of his newer technique using the peritoneum. Can you share where you found this piece?

"The peritoneum and omentum are not commonly used in the reconstruction of neo-vaginas. The disadvantages of using peritoneum are several"

Thanks!

[Lauren24]

Sorry, I hope I'm not posting excessively, but I just found the site for the lead researcher. Apparently he has a practice in Tehran that includes transgender services.

http://www.drforootan.com/en/home

Seems like a lot of western plastic surgery practices with a slogan like that.

Also this is going to be graphic but here is what I believe might be the amnion/fibroblast procedure in action

< Link removed by moderator >

I just really don't know what to make of this whole thing right now. The website seems really vague and the experiment looks like it was carried out mostly by this doctor and his family member, but the article is in a peer reviewed journal.

[AnonyMs]

It's my understanding that Iran performs some of the most GCS of any country, mostly due to their seeing it as a cure for homosexuality.

That's whats interesting about it only being 24 over 8 years. Its almost nothing. Perhaps there's some other clinics?

By the way, I'm very interested in Dr. Ting's work. I have yet to find any real review of it, yet you had a piece in there seeming to list the disadvantages of his newer technique using the peritoneum. Can you share where you found this piece?

Its from the paper linked in the first post.

I'll send you a pm with some reviews and photo's of Jess Ting's work.

[AnonyMs]

The photo's on his site look nothing like the one in the paper. They look more like cis-female than the result of surgery, although its hard to see properly due to the dilators. Seems a bit unlikely for someone who's done so few.

[Cindy]

 

Some links removed.

no ->-bleeped-<- links please