Hey guys. I have a question. I have been looking into my options for bottom surgery, and I've noticed that a couple of surgeons won't actually close the vaginal opening. For example, on Dr. McGinn's page describing her ring-flap metoidioplasty, this quote can be found:

"Vaginectomy is not required for this surgery, nor is it performed during this surgery. The vaginal opening IS however, significantly reduced to just a few millimeters."

This makes no sense to me. Prior to this surgery, the works have to be removed anyway, so why not close it? I know she uses some vaginal tissue to form the neo-urethra as well, but after that, couldn't it be closed? If it is to drain, I feel like that would be mentioned, and that after draining it would be closed at a future date. I am obviously not a doctor, however. But why wouldn't this be performed? Any insight is appreciated!

It is it's own separate procedure. Some surgeons have not learned it, and some who have not somewhat degrade the idea as if no one should want it. IF you want it (as not all folks would want it), you should NOT go to a surgeon who is unable to do it or get talked into not doing it if that's what you want). For those who do want it they are happy they had it. It does carry a risk of excess bleeding.
(BTW, it is usually not a full vaginectomy, they remove the mucosa and seal the sides of the walls. It has another name, though not sure what it is.)

BTW, each surgery during lower surgery (esp a meta) is considered a part of a procedure or maybe it's own procedure. So there is a the meta itself, the urethra lengthening, the scrotoplasty, testicular implants, vaginectomy, mons resection and so on. You can get some of these without the others.

--Jay

Quote from: chaseinspace on February 22, 2015, 07:17:21 PM
Hey guys. I have a question. I have been looking into my options for bottom surgery, and I've noticed that a couple of surgeons won't actually close the vaginal opening. For example, on Dr. McGinn's page describing her ring-flap metoidioplasty, this quote can be found:

"Vaginectomy is not required for this surgery, nor is it performed during this surgery. The vaginal opening IS however, significantly reduced to just a few millimeters."

This makes no sense to me. Prior to this surgery, the works have to be removed anyway, so why not close it? I know she uses some vaginal tissue to form the neo-urethra as well, but after that, couldn't it be closed? If it is to drain, I feel like that would be mentioned, and that after draining it would be closed at a future date. I am obviously not a doctor, however. But why wouldn't this be performed? Any insight is appreciated!

Thanks for the input! Additionally, is there an operation that would entirely remove the vagina, instead of just sealing the walls? Wouldn't there still be a cancer risk down the line for the part that would remain? I would definitely pay to remove the whole thing rather than just seal it off if that's possible...

A few months ago, I contacted a surgeon who does F to M surgeries because I wanted to rid myself of any hint of a vagina. The Dr. promptly refused and explained that it was a risky surgery, and there were very real dangers of damage to both rectal and urethral nerves. He said he could close most of the vagina, but there would still be a small opening for drainage and infection management should one ever arise.

That was someone who did transgender surgeries on a regular basis, but there are probably surgeons out there willing to do it.

sam1234

I was told it was a high risk of bleeding. I had hoped they would do it when and if I can ever get phallo done.. One dream shot down I guess.

Quote from: chaseinspace on February 24, 2015, 01:04:51 PM
Thanks for the input! Additionally, is there an operation that would entirely remove the vagina, instead of just sealing the walls? Wouldn't there still be a cancer risk down the line for the part that would remain? I would definitely pay to remove the whole thing rather than just seal it off if that's possible...

You rarely hear of vaginal cancer. Most cancers of those parts are cervical, uterine or ovarian. Aren't those parts always removed?

Funny this topic was started on the day I had the damn thing removed.
It's called a colpectomy, and they indeed remove most of the vagina. The surgeon leaves a very thin layer that sort of sticks/grows together in the days after surgery. For this reason I had to stay in bed the day after surgery, so it could settle and seal up.

This surgery is required in the Netherlands to get a meta or phallo. I have no idea why surgeons in other countries are so much against it. There is indeed a risk that your intestines are perforated, or that you bleed, but a skilled surgeon can handle it. I had minimal bleeding during the surgery. Another transman who I met at the hospital and had the same procedure done had a bit more bleeding, but nothing that was excessive.

This surgery was even done in combination with a full hysto and ovary removal, so if my surgeon can do all that in one go, surely the risks aren't sky high? I do have to add that the procedure was done by a surgeon who is part of an entire team who's sole purpose is to help transgenders from start to finish, including operations. The man is both an endocrinologist and gynecologist and has a lot of experience with transgenders. Perhaps he's just a bit more advanced than other surgeons and in the upcoming years, they may catch up and you can get the procedure done.

Did your surgeon leave any opening, or was it completely eradicated?

sam1234

It's completely closed. The thin walls collapse and seal together, leaving no hole or anything.

Quote from: Mr.X on February 26, 2015, 02:09:51 AM
I have no idea why surgeons in other countries are so much against it. There is indeed a risk that your intestines are perforated, or that you bleed, but a skilled surgeon can handle it.

This was my thinking as well, and I think I will still push for it when the time is right. If a surgeon I'm set on won't do it, I'll just find one who will after the fact...

I had the vagina completely removed too, a gynecologist removed it and then my surgeon put the muscles together and closed it. It was done during my meta surgery. A couple of years ago when I started my transition I was told there was no one in my country that wanted to perform that type of surgery because it was too complicated and the risks was to great but now it didn't seem like a problem.

There would be no need to remove every single trace the vagina. It's more than removal of the walls (actually collapses walls, but also of the vaginal mucosa).  The surgery performed is much MUCH safer than a traditional vaginectomy. Cancer risk would be dubious as vaginal cancer is rare. Of course  they always perform a complete hysterectomy as they can't screen for anything anymore.

I don't think surgeons in the US are against it, but some are not experienced with it and don't understand it. Some of these have big names so their influence might be higher than they should be. It is not normally required here, since there are still guys who do want to keep their vaginas for various reasons, or do not want the surgery. There are still risks and each procedure adds to the risk, and some guys do not have strong feeligns about it one way or another.

You can NOT convince some surgeon to perform this who does not want to.  I see this over and over in this forum. You must go to a surgeon who can do the types of surgeries you want.  You can not change your surgeons mind. Surgeons need to know and be comfortable with procedures. You want one who knows how to do what you want. Some surgeons can NOT do a UL, do you want someone to learn on you? If you think otherwise, you need to consider why you want this surgeon. There are several outstanding surgeons who do this (Crane, Metzger, Salgado, Schectler, etc etc. and this is just the US.) Would you want to take a night flight on a plane if the pilot can't fly on instruments? This is a fairly good analogy of the situation I see here all the time. The other possibility is to go to another surgeon for this procedure, but not sure why you'd want to do it this way.


--Jay

Vaginectomy is a surgical procedure to remove all or part of the vagina.

Colpectomy removes part of the vagina.

Subsequently, when you get a vaginectomy, the surgeon can stitch you up completely (Crane), while a surgeon who does a colpectomy (McGinn, for example), needs to leave a drainage hole.  Some surgeons will say they do vaginectomy, but they really mean colpectomy.  Vaginectomy results in the look of a male perineum.  The same cannot be said for the colpectomy, as there is still a hole there.  Make sure to ask your surgeon which process they use.  I believe that at times the words are used interchangeably, so be specific about the end result in your discussion, rather than relying on the language itself.

Maybe someone can come in and explain the specific differences between the two of them.