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Laparoscopic peritoneal pull-through vaginoplasty- testimonials, anyone?

Started by Sarah.VanDistel, January 07, 2019, 01:30:28 AM

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Sarah.VanDistel

Hi girls!

After 2y1m under HRT, I'll be having SRS (together with BA) exactly 73 days from now.

I'll be operated by dr. Houtmeyer's team in Sint-Niklaas, Belgium. He'll be using a recently "rediscovered" technique for my vaginoplasty: laparoscopic peritoneal pull-through, in which the peritoneum is used to create most of the vaginal canal (instead of just penis inversion or colon). Besides a better lubrication, it supposedly needs less frequent dilation and in my particular case, HRT has induced a very significant atrophy of my external genitalia, which would otherwise imply skin grafts. With this "new" technique, skin grafts would not be needed.

The technique is not really new. It has been successfully used for a number of years to correct vaginal agenesis in cis women born with this condition. It's its application to SRS that is recent.

Anyways, I'd like to know if other girls here have undergone their SRS using this technique. Did they encounter particular problems? Unexpected developments? How long until a pleasurable penetration (even if I know that this depends on a lot of other factors...)? Do you still need to lubricate? Troublesome odours (I read that that can happen when colon is used...)?

Please, excuse my ignorance and I hope someone will be able to answer my questions... I'm looking so much forward to that moment. It will be the final crown on my transition - hopefully the last physical piece in this transition jigsaw!

Warm hugs,
Sarah [emoji2300][emoji3448]

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Chloe

       Sarah Dr. Marcio Littleton of Brazil uses similar technique am very interested, will follow your progress! He has a member account here @ Susan's search "Dr_Littleton" posts and his website "Q & A" page is here -> marciolittleton.com/perguntas-frequentes-mtf (google chrome can translate)

Keep Us Posted! 8)  ;)

(ps: I see Dr. Houtmeyers' transgender surgery page doesn't really go into details)

"But it's no use now," thought poor Alice, "to pretend be two people!
"Why, there's hardly enough of me left to make one respectable person!"
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Sarah.VanDistel

Hi Chloe!

Thanks for the link - I'll check as soon as I get home! And no need for translation, as I am fluent in Portuguese. [emoji6]

Hugs, Sarah

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Sarah.VanDistel

@Chloe

Oi Chloe!

Just checked out your link quickly. It's a different technique from dr. Houtmeyers, although both techniques have been used for similar purposes (vaginal agenesis, etc).

The peritoneal pull-through vaginoplasty used by dr. Houtmeyers is perhaps less invasive, as the instestine is left untouched. The neo-vaginal pouch is covered with peritoneal mucosa, which is the serous membrane covering the intra-abdominal organs as well as the inner abdominal wall; this pouch will constitute the neo-vagina. The male external genitalia are used to construct a neo-vulva and clitoris, with appropriate positioning of the urethra.

The technique by dr. Littleton, on the other hand, uses a flap of jejunum, which is a segment of the small intestine. The end results look similar (better lubrication, lesser need for dilation...), though. I did not find any study comparing the two techniques.

Dr. Houtmeyers gave me a very complete explanation during my consultation, but I just wanted to know from girls who went through this kind of surgery, if there are other less common or more practical issues that I should be aware of. I'm seeing dr. Houtmeyers again in February (pre-op consultation) - if I have have any news I'll let you know.

In any case, I'll try to keep this thread updated.

Com carinho,
Sarah [emoji2300][emoji3448]

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josie76

Sarah, you are looking quite pretty girl!  :D

I found studies before that compared ileal (small intestine) to peritoneal when used for Mullerian agenesis and CAIS and upper grade PAIS patients. Both performed as expected but the study showed significantly lower blood loss and complication risk with peritoneal. Surgical times were also much shorter. Some later studies following patients of peritoneal vaginoplasty showed that the peritoneal tissues become almost indistinguishable from natal vaginal lining tissues after 6 month to a year. This is because the outer layers of the peritoneal tissues have epidural like cells for the membrane but continue to allow the inner cells secretions through. The secretions are pH similar to natal vaginal secretions as well.
The worst case I found in one study, the patient did not do any post surgical dialation. Only a cotton swab could be used to check depth due to stenosis (shrinkage of diameter). Depth was unaffected.

Dr. Gallagher said she has been working with the laproscopic surgeons to be able to offer this in Indianapolis soon. My insurance won't cover it so I never heard any more info after that. The University hospital there requires some insurance coverage to even schedule you. They simply won't do self pay.  >:(
There are doctors who do the procedure for women with MKRS in the US. Dr's Milkos and Moore do it and say it takes 1-1.5 hours but they do not do genital reconstruction.
Dr. Whitehead, who now runs the Reed Center in FL, has done it before when he worked in the hospital setting, but the Reed Center is not equipped for it. (he doesn't own his own laproscopic equipment)
Dr. Bluebond-Langer has done a shorter version for revision of past inversion inversion type vaginoplasty.
One of the SRS doctors in Serbia recently did similar for revision purposes.
The SRS surgeons in Mumbia have done a pilot group of 2 or 3 transwomen with full SRS.

The PPV is a type of Modified Davydov Method.
04/26/2018 bi-lateral orchiectomy

A lifetime of depression and repressed emotions is nothing more than existence. I for one want to live now not just exist!

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Tamara Tilly

Hi Sarah,

What news of your surgery? Did you go ahead with peritoneal pull-through? I'd be really interested to know if so and how it was for you.

Tamara xx
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