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Looking at peritoneal vaginoplasty with Dr. Gallagher

Started by josie76, February 13, 2019, 06:31:53 AM

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josie76

In the next week my spouse is starting a job with health insurance that actually has GCS coverage!  :o :D I'm excited by this. In all my research into peritoneal vaginoplasty I found out that Dr. Gallagher at the IU Hospital in Indianapolis IN, is going to be offering a version of this procedure.

Otherwise I have been looking to PriyaMed in Mumbia as they are they only ones who have worked with surgeons to offer a version of this for transwomen. Now their doctors have created a procedure that does not use any penile inversion. I can only guess that they use the inner scrotal tissues to form the vestibule area and they connect the peritoneal tube to that.

Dr. Gallagher is working with the general surgical dept at the university hospital there and she will still use the penile inversion for the outer entry point of the vaginal canal, attaching the peritoneal tube to that.

While I find the idea of PriyaMed's version sounds very intriguing, having insurance that will cover GCS right here in the US and within a days driving distance from my home is sounding better and better. In the end it may come down to money.  :( I will have to see with this insurance, they will pay for "out of network providers" but a percentage. Then there is a $6000 max out of pocket so it comes down to how much will it cost here verses the cost of travel to India and the procedure there (around $15k).

Both providers intend on offering this fully this spring/summer.
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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Anna994

I wish you good luck! The best I can offer you is some advice considering I've had the peritoneal method done (As a revision, attached to the previous penile inversion).

Dilatation is way less intense, I do it twice a day seeing as it's been about 2.5 months since my surgery. However, very often it happens that I skip a dilatation, I've even done once a day for almost 4 or so days in a row, I didn't get any tighter at all or felt changes.

It's very wet, expect to need pantyliners, but it's not so wet that you'll need pads, the wetness coming from the peritoneum is a thin liquid, doesn't really smell like much, just smells like "wet" and at times it can have a slightly (extremely slightly) red or yellow hue, this is mostly due to it mixing with some remaining urine or blood.

As I am the very first one to have this done in my country, we have been establishing a protocol with my doctors based on my case. We've concluded that the best kind of dilator for this procedure is silicone, the peritoneum is quite fragile and doesn't require all that much dilatation. It becomes less fragile over time as it begins to morph into something ressembling vaginal tissue, but for those first 3 months, silicone dilators are very comfortable, less risky and dilate you more than enough. Do bring this up with your doc of course!

Mine was done laparoscopically, so I have laparoscopic scars, one in my belly buttons that's invisible, 3 more around it, hidden by panties, they are 1/4 inch incisions.

Anything else you might wanna know, please do hit me up I'd love to share as much info as I can <3
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josie76

Thanks Anna.
I am FB friends with one of the girls who had the pilot surgery done in Mumbia. She has been very informative on her experience. I like the idea of the way they have done the surgery, no penile inversion. In doing it that way there was none of the need to stretch and cut the skin so much.

I have concerns about the only surgeon here in the US who is offering it. I have only been able to communicate with 2 of her former patients. One is happy with her results, one has had an aweful time with scarring and not being able to get it fixed. This leaves me concerned.

I know there are patients from almost every surgeon who has problems. One lady I know personally has just returned from Montreal and still has the cathider in place. She has had some trouble finding a doctor who will remove it now. There are bad stories from Chicago. The are many, many girls who end up getting revisions just so they can pee correctly.

All of this actually makes me consider traveling to Mumbia more. I have contact with quite a few who have had surgeries there in the past and leave with everything working properly the first time. It's almost as if the surgeons there are more careful than those here in the US.
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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josie76

As an update,

I have been able to hear from 4 more patients of Dr. Gallagher through Facebook. All were happy with their results, doctor, and staff. Seems the patient coordinator that caused issues for some in the past is long gone now. One lady said 2 of her friends are scheduled to have Dr. Gallagher do their GCS later this year.

I know one member here who previously reach out and shared her blog with her extremely negative results and interactions with that practice. Is there anyone else on here with either positive or negative experiences?
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!

  •  

chinee

Quote from: Anna994 on February 14, 2019, 02:43:10 AM
I wish you good luck! The best I can offer you is some advice considering I've had the peritoneal method done (As a revision, attached to the previous penile inversion).

Dilatation is way less intense, I do it twice a day seeing as it's been about 2.5 months since my surgery. However, very often it happens that I skip a dilatation, I've even done once a day for almost 4 or so days in a row, I didn't get any tighter at all or felt changes.

It's very wet, expect to need pantyliners, but it's not so wet that you'll need pads, the wetness coming from the peritoneum is a thin liquid, doesn't really smell like much, just smells like "wet" and at times it can have a slightly (extremely slightly) red or yellow hue, this is mostly due to it mixing with some remaining urine or blood.

As I am the very first one to have this done in my country, we have been establishing a protocol with my doctors based on my case. We've concluded that the best kind of dilator for this procedure is silicone, the peritoneum is quite fragile and doesn't require all that much dilatation. It becomes less fragile over time as it begins to morph into something ressembling vaginal tissue, but for those first 3 months, silicone dilators are very comfortable, less risky and dilate you more than enough. Do bring this up with your doc of course!

Mine was done laparoscopically, so I have laparoscopic scars, one in my belly buttons that's invisible, 3 more around it, hidden by panties, they are 1/4 inch incisions.

Anything else you might wanna know, please do hit me up I'd love to share as much info as I can <3

Im interested with this kind of revision as I have done penile inversion  5 years ago.

my question is how soon can you have sexual intercourse after the peritoneum revision? Im worried that it is very fragile and being sexually active.
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Anna994

Sadly, I am my doctor's first patient. We're being very careful and waiting for the 6 months mark before sexual activity. I'll deffo update my own topic once it happens with all of the information.
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josie76

I know a girl on FB who was one of the three to get the pilot surgery in Mumbia with PriyaMed. I think she mentioned it was around the 3 month mark or so. One of their patients let them do a biopsy and at 3-4 months the peritoneal vaginal lining is indistinguishable from cis vaginal lining tissue under a microscope. This was something that earlier studies on cis-girls with Mullerian agenesis had shown as well.

I have been emailing with Dr. Gallagher's PA. Dr. Gallagher is open to discussing doing it without penile inversion so I'm pretty happy hearing that. I hope to have my second WPATH letter next week. Then its up to finding out how well this new insurance is going to be.
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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josie76

Quote from: Anna994 on February 19, 2019, 05:28:11 PM
Sadly, I am my doctor's first patient. We're being very careful and waiting for the 6 months mark before sexual activity. I'll deffo update my own topic once it happens with all of the information.

Anna, did you have to use an estrogen cream vaginally for the first three months?
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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Anna994

No, I wasn't instructed to use an estrogen cream ^^
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Kaley

Wow, thanks for all the info!
What was the best way to get in contact with Dr. Gallagher's office?  I'm in Hawaii so calling is always hard to arrange.  I filled out the form at  (https://universitygenderaffirmationsurgery.com/contact) but wasn't sure if there was a more direct route?

I'm actually scheduled for surgery with Dr. Bowers soon (seems like I've been on her wait list for forever now...), but am really intrigued by the peritoneal method.
I haven't seen/heard from many other previous patients who have had this procedure, but it seems like overall feedback has been pretty good!
I guess I'm having second thoughts about the standard surgical procedure and don't want to go through multiple surgeries if I don't need to.
Alright, well please keep us updated!
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josie76

That online form is the simplest way. That or their generic email askus@universitygenderaffirmationsurgery.com. Emma is the new patient coordinator. She gave me a direct email to send my letters to her.

So at this point I have sent:
my first letter from therapist, masters degree, long term relationship
my hormone therapy letter from my endocrinologist
a copy of my new insurance transgender policy from their web site
a copy of my new insurance card
My second therapist is supposed to send her letter directly

Now I wait to see what they figure out. After verifying insurance coverage they should contact me and let me schedule a consultation appointment. After this happens I will know more.
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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thebeardedlady

Best of luck! I am interested in having this procedure done and hope to hear great news about your experience.
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Ann W

@josie76

Thank you for sharing your experience.

I like what I've heard about this procedure; and my sister lives in Indianapolis, which means I will have help if Dr. Gallagher does my surgery. I will be following your progress closely.
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josie76

Well my second therapist did not directly send the letter but I am meeting with her later today to pick it up. Then I can send it on. I have not heard anything back about my insurance as of yet.
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!

  •  

gracefulhat

Thank you!!!!!!! For posting this thread. I know multiple grs patients of Dr. Galligar who are pleased. I will be able to be placed on her waiting list this August and had recently seen Dr. Galligar YouTube video discussing the peritoneal vaginoplasty which seems more ideal to a cis vagina. I didn't realize she would be offering this so soon and it makes me so relieved. Also, didn't Jazz Jennings surgeon perform a peritoneal vaginoplasty for her since she lacked tissue?
Above all, love
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josie76

Quote from: gracefulhat on March 20, 2019, 08:22:48 AM
Thank you!!!!!!! For posting this thread. I know multiple grs patients of Dr. Galligar who are pleased. I will be able to be placed on her waiting list this August and had recently seen Dr. Galligar YouTube video discussing the peritoneal vaginoplasty which seems more ideal to a cis vagina. I didn't realize she would be offering this so soon and it makes me so relieved. Also, didn't Jazz Jennings surgeon perform a peritoneal vaginoplasty for her since she lacked tissue?

So there is a huge misconception about what is a peritoneal vaginoplasty.

Dr. Ting used Peritoneal like tissue from the scrotum to stitch inside of an inverter penile vaginoplasty. Not the same.

A number of doctors will use scrotal skin with this same type of tissue still connected to form the bottom part of a penile inversion as a standard practice. However you still have a length of regular penile skin first. Also neither surgical style does away with internal scar issues when healing.

I know one lady here who had a partial true Peritoneal vaginoplasty some years ago as a revision surgery to correct lost depth done by Dr. Bluebond-Langer.

So what we are really talking about is a true Pull through peritoneal vaginoplasty. This is done with the Peritoneal pouch inside the abdomen. Now Dr. Gallagher's plan was to still use penile inversion with the peritoneal tissues connected inside. This would be like the revision done by Dr. Bluebond-Langer and the Dr. in Serbia.
What we are talking about is a laproscopic Davydov Method vaginoplasty with full exterior reconstruction. This is what has not been done before last year in India. I have found cases published where a PAIS girls had it done where they had "ambiguous genitalia" so a reconstruction but with less than functional male genitals to start with.

I think the theory is fine. It's just getting doctors to actually do this procedure for us that is the issue.
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!

  •  

Ann W

@josie76

Have you been filled in yet on Dr. Gallagher's standard pre-operative requirements? Some surgeons require a lengthy program of electrolysis, for example. I'd like to make sure I complete all her requirements so that I am ready to go as early as possible, once I have the money and, of course, am accepted as a surgical candidate.
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josie76

Quote from: Ann W on March 20, 2019, 09:45:37 PM
@josie76

Have you been filled in yet on Dr. Gallagher's standard pre-operative requirements? Some surgeons require a lengthy program of electrolysis, for example. I'd like to make sure I complete all her requirements so that I am ready to go as early as possible, once I have the money and, of course, am accepted as a surgical candidate.

So Dr. Gallagher used to require clearing of hair. Now she does not.

I am finally on the schedule for a consultation at the end of the month! I will know more after that.
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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AnonyMs

Quote from: josie76 on April 04, 2019, 06:14:40 AM
So Dr. Gallagher used to require clearing of hair. Now she does not.

She has a YouTube video where she discusses hair removal where she basically says she doesn't recommend it because it doesn't work, not because its not needed.

Also, there's a new patient post on realself with photo's and all. Its not good.
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josie76

That's the same patient that had such a bad time with her. Awfull for her but she seems like the only one I can find who had such a result. IDK why. She has written her story several places. I can understand why she does, but again she seems to be the only one. Terrible to be stuck in her situation.
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!

  •