Hello everyone,
It has taken me 12 years to pluck up the courage to post this, or even to seek any help. I feel uncomfortable writing this as it's mostly negative, but it's really affecting my life, in a bad way, so I feel like I need to finally seek some advice.
Sorry if I break any forum rules, I don't mean to.

I had SRS with Sanguan Kunaporn in 2003, and to be honest, it was extremely difficult and painful and the eventual outcome wasn't good. OK, I could dilate, and use the largest diameter dilator out of the 5 that he supplied, and I got to about 4.5 - 5 inches in depth.
His instruction was to dilate every day (for 30 mins I think?). I religiously did this, but I found it extremely painful. And as time wore on, after about 4 months the pain was getting worse, and even getting to 4" depth was a problem. I was plagued by continual infection, thrush, bacteria, everything.
I saw my GP and he took some swabs, and they came back as just "everyday" bacteria we all have on our skin.
Nothing he could suggest would help, and I tried a lot of different products, washing, not washing, etc etc and nothing helped.
I am based in the UK, and so I paid to go and see Mr. Thomas in a private hospital in the South of England (can't remember where), and he was pretty brutal and I was so sore that he had to put me under with a general anaesthetic just to perform an examination. When I told him I'd had the operation in Thailand, I could see he immediately rolled his eyes as if to say I deserved it. Anyway he could find nothing wrong, and could not explain my problems or help me at all.
After 6 months of daily dilating I finally gave up as it was just too much pain for no real gain. I was in way too much pain to have vaginal intercourse with my then boyfriend anyway.
After I stopped, things eventually calmed down "down there", and as my relationship at the time went off the rails, I reasoned that I didn't "need" depth.
Health and comfort wise, things were much easier after I stopped dilating, although I still get soreness and infection and thrush about once a week, plus occasional unbelievably sharp internal "phantom pains". But it was all more cope-withable as long as I put my sexual desires and anatomical "failure" out of my mind.
Believe me, after suffering long-term sexual and physical assault and abuse from a couple of male ex-partners (all after my op), plus a couple of suicide attempts to boot, it was easier to just try and forget.
Plus, I had a huge hang-up that admitting anything at all was wrong post-operatively would just incite comments like "you shouldn't have done it!", "you deserve it!", "see you're NOT a woman after all, and this proves it!"
So I kept schtum.

Fast forward to now, and I have a wonderful loving heterosexual male partner, and the issue of vaginal intercourse has once again come to the forefront of things.
I haven't dilated for 12 years, and I really don't know if there's anything I can do about things down there?
The fear of pain is still on my mind, but I really feel inadequate as I am and it's got to a point now that I'm pretty unhappy and it's causing issues in my life as a post-operative transexual woman who has been living in complete "stealth" for many years now.
It's been very difficult to write this all, and any advice anyone can give me would be gratefully received.

I'm pre op so the only thing I could suggest is talking to a surgeon and or a therapist.

Im in no position to say what exactly went wrong after your surgery, that made your dilations too painful to dilate. I can only guess. I dont know what were you instructed, and how much and how often to dilate... but 30 minutes per day doesnt make any sense. 30 minutes might work for someone, and all they need is 15 minutes two times per day. Someone else might need 3 hours per day, 3 sessions each 1 hour. Someone else might need 4 sessions per day. You body is telling you how much it needs. If it becomes painful, and if it takes too much time to reach full depth, or if you even cant reach full depth, it simply means you need more dilation, otherwise it just becomes harder and harder and more and more painful. If surgeon and his team didnt explain you this clearly, its also their fault why you had problems.

Whatever inflammation or infections happens in first year post-op, you just need to work through it. If it makes everything even more painful, you simply need to dilate even more. Inflammations are simply to be expected, and are normal during first year as tissue heals, and a lot of cells die, and you make small ruptures with dilation, and lube stays it... and everything starts to ferment even if you douche extensively after each and every dilation. This is normal... and can make everything very uncomfortable and painful. Betadine pessaries or later probiotic pessaries are helpful with that.

What you can do now? If depth and width is lost so early in the recovery stage, you simply cant do anything about that. The only realistic option is to have colovaginoplasty, with either jejunal or sigmoid segment.

Im really sorry for the ordeal that you have had to go through. Whilst I am also pre-op I cannot relate to the specific issues you have experienced - but noone deserves this or to be treated in that way.

Welcome to Susan's Place. This is a support site, something it appears you are badly in need of and you haven't broken any rules. As you stopped dilation so early, I don't know if intensive dilation would help you recover what you have lost as scar tissue may have already formed. There are a number of known revision surgeons available and some of the members have had revision surgery for one reason or another. I am in the United States and live about 30 miles away from one but there may be one located closer to you. Unfortunately follow up care can be a problem and I was fortunate that I had a local doctor that could treat the issues I had post surgically. Not everybody has that available to them. If there is anything I can help you with, let me know.

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Thank you to all who have replied, and I sincerely mean that.

mmmmm, The advice you wrote would have indeed been very useful to me at the time. I got no such advice from my surgeon in Thailand, or Mr. Thomas, or indeed my therapist at the time. But back in 2003 things were not as open as they are now, and the online support networks that exist today simply weren't around back then. Or if they were, I didn't find them.
But thinking about it, back then I had had my fill of surgery and "jumping through hoops" at the time, and with the other aspects of my life going on back then, it was easier to give up dilating, even though I bitterly regret it now. My SRS consisted of 3 procedures, over 3 weeks, with the first being the major one. There were complications and the first surgery took nearly 9 hours, and I nearly died. My body really did not like what was being done to it!

Of course I had (and still have) a massive chip on my shoulder about having to go through all this 'stuff' just to be who I am, when the vast majority don't have to deal with all this, any of it. Believe me I would rather have not gone through it if there had been some other option.
I do have to try hard not to become consumed by bitterness as I have found my life extremely tough at times, and I tire of it.
All my other post-op TS friends at the time made out that their surgery was a breeze, and had zero problems and fantastic outcomes. I was young and totally believed them, and thought mine would be too. Nope! Big wakeup call that was!
And the funny thing was, afterwards when speaking to my pre-op friends, and trying to tell them that surgery wasn't "all sweetness and light", all I got was aggro, and some of them simply no longer wishing to talk to me. I found out that gritty realism is not popular at all in TS circles! Hence me taking 12 years to get the courage to post on here, my first contact with the 'TG Scene' (for want of a better term) for 12 years.

It appears my worst fears are true then, my only option is more costly and unpleasant surgery.
Ignoring the psychological aspect of having to face such an ordeal again, my life as it is now, living in stealth, with my partner's family not knowing, and his young son living with us from a previous marriage, and me being 'mum' and 'wife' and all. I also know for an absolute fact that his family would NOT accept me if they knew my past. So trying to find the money and time for more major surgery and then trying to conceal stuff like having to dilate regularly at home... well it just isn't compatible. And I don't want to risk losing the life I now have.
Some choice huh?

Like I said, life is tough, and I am tired.

Once again, thank you for your kind replies, I really appreciate it.

If you need a cover, some CIS women are born without a vagina and the procedures for treating them is much like what we face. My surgery was a single procedure in 1982 and my follow up was handled by a gynecologist who was at least familiar with the treatment of conditions like this. I would need a revision if I wanted my surgery to appear more correct but I am comfortable with the results so I will not seek a revision.

I would suggest you consider contacting a gynecologist and having them take a look for an evaluation. It wouldn't cost much in the way of travel expenses or doctors fees and it would give you more information to work with.

As for this site, we are heavily moderated and we keep a tight lid on criticism. Should you have a problem with anybody on this site, hit the report button on the post and a moderator will deal with the issue. Most likely you will find the members very helpful and a wealth of information.

This is an inclusive site covering all areas of ->-bleeped-<- but I refer to myself as a former transsexual. You are free to identify however you feel comfortable as other on the site will identify however they feel comfortable.

I'm afraid I don't have any practical advice for regaining depth (though you do have my sympathy), but what struck me from your message is that "soreness and infection and thrush about once a week" is NOT normal. I know you had little luck treating that in the far past, but it might be worth trying again, because constant infections is not going to help either your daily life/comfort or any future efforts at repairing the issue. If you can get that under control, you might find that dilation - whether it's fully successful or not - becomes tremendously more comfortable.

Good luck.

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V:

My sincerest empathies to your predicament.

Can you slowly try dilating again using only your smallest appliance until you feel comfortable advancing to the next size?

Maybe find a smaller size and re-start with that?

What kind of post-op specialists are available at UK?  Here at Arizona, there are gynecologists who specialise in M-F post-op of all conditions.  Maybe you'll find someone at your region with that speciality.

Revision can help.  Have you considered revision?  Maybe by one of the 'Big 3' surgeons at Thailand?  Or a surgeon closer to you?  Today's surgery / revision is light-years better than our past options.

Was your original surgery (any or all of your three operations) done correctly?  Maybe one part or all had complications and no one informed you?

Some complications are dietary; maybe eat yoghourt (real yoghourt, not chemical yoghourt).  Some surgeons do NOT recommend douching as long as you use absorbable lube.  I have never douched in all my years and have never had any complications.  Of course that makes me feel bad for you and others - 'YMMV'.

You WILL find a way to improve your anatomy and your life.

Please keep trying!

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Thank you all for the further replies and kind support you offer

@Sharon, I have though about trying to dilate a little myself, but I am rather scared to. Not sure if that makes sense.
I did try a little with my finger, that was possible to around 2", but it didn't feel good to do so, and I am paranoid about damaging something. Having nails doesn't help here!
I also tense up 'down there' when I try, which makes things doubly difficult.
Maybe my pubic bone is particularly poorly arranged to allow dilation? I dunno.

Actually reading through some other posts on this site, I came across one where someone's neovagina would almost close up when they got aroused. Something to do with leftover erectile tissue or somesuch. That post really struck a chord with me, as I think I have that problem too.
<sigh>

I know of no post-op specialists in the UK, indeed posting on a forum such as this was my tentative way of trying to find out such info.

You mention seeking surgery and possibly going back to Thailand again, but as I posted, my circumstances now make that very difficult. My fear of losing the life and family I have now, outweighs my need to 'sort out' my anatomical issues. Thinking about that just makes me bitter.

How would I know if my surgery was done correctly? Like I said, Mr. Thomas examined me 5 months post-op and could find nothing wrong.

I can't eat yoghurt, as I have a dairy intolerance. Actually, I'm pretty healthy, I exercise, don't drink or smoke or take drugs. I only drink water or juices. Yes really! My BMI is within the ideal weight-for-height range. Not sure what else I can do, health-wise?

@Jenna, I use Canesten thrush cream, when things get sore or swollen 'down there', I put some on, and 75% of the time it clears things up.
My hayfever and high summer levels of histamine can cause painful sensitivity and swelling there too, which I treat with anti-histamines.
My GP and I have run out of things to try, and he's no gender-specialist.

It can also get sore if I walk too far (for more than an hour), and riding a bike is completely out of the question, unless I don't want to sit for the next few days. What a silly compromised life I end up living.
I am conscious that I sound like I'm wallowing in self-pity, I don't mean to.

@Dena, I had never heard of that condition that cis-women can have. My fella's mum is a nurse, so I try not to do anything that would cause her to become suspicious of me. I'm pretty sure that she'd jump to the conclusion that I'm not cis-gendered if I tried to say I was born without a vagina. I mean, she's already dropped enough hints that she wants grandchildren, and we just laugh it off. Ha ha ha (

What I did do, after the responses I got from this site, was to contact my surgeon in Thailand, for the first time since my op.
Not sure if he'll reply, and if his answer is to go back to Thailand for more surgery, I'm not sure I can do that, for reasons I mentioned earlier.
But at least it's a small step I guess.

Thanks again to you all for your kindness.

V

Hi,

One thought I  had was to post on here with an inquiry to see if anyone knows of a trans-friendly gynecologist near you. Get the exam and see what they say.  You may have to pay for such an exam.


Hugs

Jen

Quote from: V on June 28, 2016, 06:28:27 PM

It appears my worst fears are true then, my only option is more costly and unpleasant surgery.
Ignoring the psychological aspect of having to face such an ordeal again, my life as it is now, living in stealth, with my partner's family not knowing, and his young son living with us from a previous marriage, and me being 'mum' and 'wife' and all. I also know for an absolute fact that his family would NOT accept me if they knew my past. So trying to find the money and time for more major surgery and then trying to conceal stuff like having to dilate regularly at home... well it just isn't compatible. And I don't want to risk losing the life I now have.

If 2" with the finger felt painful and uncomfortable, Im not really sure what can be done and achieved with dilation now after all these years. Im trying to be as realistic as possible... if you lose depth early in the recovery, its likely lost forever.

As for revision colovaginoplasty.. there isnt any dilation required for depth after that surgery. Only dilation is needed for vaginal entrance where is scar tissue.

You dont have to go back to Thailand for revision. There are good surgeons in Europe who do this kind of revisions on a regular basis. Dr. Djordjevic in Serbia is well known for doing good work with revision vaginoplasty, as well as fixing other issues, like erectile tissue removal, etc...

Colovaginoplasty revision is a lot more common than most people realize. Its just not one of the popular topics, and one of those things that people like to share about online. And many dont like to advertise that they made a mistake with original surgery, and that things went wrong, and that they had issues... like you said, you pre-op friends didnt want to hear much about your experience. People like to hear and read about how everything went perfect, as they imagine how everything will go perfect for them too. Reality is: many seek revision vaginoplasty after they either failed to dilate for various reasons, or they had other complications, or a surgeon simply wasnt able to give them enough depth.

Im sorry you had to go through this... hopefully you can find a solution that works for you.

Pre-op here...reading your description of the vaginal irritation (infection?) as being comprised of normal surface skin bacteria, suggests to me there may have been a cleanliness issue? Like hands, vulva, and/or dilators weren't thoroughly washed prior to use?

That, or naybe the water itself had some contamination?

Sorry to hear about your pain and struggles. 

Hope things can get better!

(Beth Andrea: in post-op women who lack the normal vaginal flora, it's pretty much expected that the bacteria found will be "normal skin" types; the lactobacilli in particular help keep those under control, as well as yeast, so in their absence other bacteria will flourish instead.)

V: Those creams carry warnings in the US that if the problem doesn't go away or recurs frequently it's important to stop using them and consult a doctor... possibly your over-the-counter treatments are different, or the warnings are, but if you're treating it once a week or so for years you risk creating resistant colonies who will laugh off the medicines and then come back (which would explain why it happens so frequently). I'm sorry your GP has nothing to offer, though. It's also odd that histamine has an effect, and I'd think a doctor *would* be able to use that to help diagnose the problem!

What I saw was a long time ago so I don't recall all the details or the name but a search turned something up that fits.
http://www.acog.org/Resources-And-Publications/Committee-Opinions/Committee-on-Adolescent-Health-Care/Mullerian-Agenesis-Diagnosis-Management-and-Treatment

Ooh, more replies! I must admit that talking about this has helped me far more towards acceptance of things than I ever thought it would.
For this I am very grateful to everyone who has replied.

@JLT1, I will look into the gynecologist route, but the kind of exam using a speculum is pretty much out of the question, so I do wonder what a gynecologist could really do for me? I'll not lie, the idea actually terrifies me.

@mmmmm, My little 'self examination' wasn't painful from a depth point of view, more that there is considerable pain at the opening. There always was right from day one. I naively thought it would eventually go away, but it hasn't, hence having to be put under GA for an internal exam! I will have to go and root about in the loft and see if I still have my dilators, and if I have, maybe see how it feels again. Thinking back, the actual sensation (and I mean physically, not mentally) of having a dilator inside me was not a pleasant one. It felt odd, and not in a good way. Not like I'd imagined or hoped it would feel. That was another factor in me giving up on it. A poor excuse, I know.

I will look up Dr. Djordjevic and see how I feel about that. Of course now that the bigotted idiots in my country have voted to leave the EU, the cost of any surgery abroad has gone up a fair bit
I wish I knew where folks got all this info from, I must be pretty poor at Internet searching.
I find it very interesting indeed what you say about Revision Colovaginoplasty, and that dilation isn't needed to maintain depth. Why is that may I ask? I certainly didn't realise it was as common as you say. But I know first hand that the post-op TS community does not want to talk about such things. Successes and sugar coating? Yes! Realism and the fact that sometimes it doesn't work out? Nope, not at all. And that is a really bad thing. It would have helped me back then to talk about it.
I will at least look up revision surgeries, are there any good resources where I could try?

I did have this daft idea of taking a plaster-cast of my fella's willy, and telling the surgeon to "make this fit". Lol!! I gotta try and make light of it or I'll end up depressed and worse, again.

@Beth and Jenna, I did try to be scrupulously clean, and I was actually told that it's possible to be too clean, as we need certain micro-organisms on our skin for normal health. I'm not sure if that's true, but my GP and I spent a few years and lots of swabs and lab tests trying to get to the bottom of it. I will admit I'm not the most tenacious of characters though. My motto is unfortunately "If at first you don't succeed, then try and try and then give up, some things are not meant to be".
Histamine certainly contributes to the irritation of the whole area, and the labia in particular swelling up, geting very red and sore, and some unpleasant discharge. The same can happen if I walk too far, as the two 'halves' rub together and it eventually becomes unbearable. If I let it get that far, I then can't sit down either. There are definite do's and don'ts, that I have learnt, to avoid aggravating my genital area. I have found that just washing the area with water (with a shower head) and nothing else, seems to get the best results, but if I touch my vagina much, infection usually results. This makes me sound unclean, which I most certainly am not.
I hear what you say about using the cream too often, and it losing it's potency, but the immediate relief it brings just outweighs that risk for me.

@Dena, thanks for the link. Not sure if it will help, but any new information is welcome and I have learned something new.

Once again, I thank you all most sincerely for your time in posting replies.
It all helps

Quote from: V on June 29, 2016, 06:06:23 PM
I wish I knew where folks got all this info from, I must be pretty poor at Internet searching.
I find it very interesting indeed what you say about Revision Colovaginoplasty, and that dilation isn't needed to maintain depth. Why is that may I ask? I certainly didn't realise it was as common as you say. But I know first hand that the post-op TS community does not want to talk about such things. Successes and sugar coating? Yes! Realism and the fact that sometimes it doesn't work out? Nope, not at all. And that is a really bad thing. It would have helped me back then to talk about it.
I will at least look up revision surgeries, are there any good resources where I could try?

I did have this daft idea of taking a plaster-cast of my fella's willy, and telling the surgeon to "make this fit". Lol!! I gotta try and make light of it or I'll end up depressed and worse, again.

This site may be the largest transgender site around and you have hundreds of people searching, learning and posting. After my surgery I disconnected from the community for almost 30 years and in that time the internet came into existence and all these sources became available. A year and a half ago when I was looking for information, this site turned up pretty quick. Over the last year I have spent about 160 days worth of time reading most everything on the site and I still haven't done more than scratch the surface. I find I am just about staying even with the new stuff that's being written.

As for place to look of information, there are two places. This section of the forum and gender correction would be where the moderator would put this type of information.

My surgeon told me to go to a dirty book store to buy my dilator. I was told to pick out something that was the same size as I was before surgery. You might save your fella some embarrassment by using the same procedure to obtain an example.

If nothing else, you probably would find it validating to go back through the years of posts in this section and the "gender reassignment surgery" section; there's dozens and dozens of people admitting to problems and complications, and working through them. Some of the science and medicine that's more than a couple years old may not be accurate, but in terms of feeling less alone as someone with issues, it might be invaluable.

Hello V, this is unfortunate to what you have gone through. Sadly, sometimes doctors that are in an area that is easy to get to and have an examination are not always the ones that will provide proper information to what is happening here so it might be a good idea to find other doctors outside of your immediate vicinity to consult with.

It might turn out to be that your body in one shape or form has rejected the changes made below and sadly may be that nothing can be done yet on the other hand perhaps there is, I found this site (has images not appropriate for children showing before and after images) http://srsmiami.com/revision-of-vaginoplasty that offers a reconstructive surgery but is not in the UK but perhaps there is a similar place in reach within your area.

Also found Vaginal stenosis: Narrowing of the vagina due to a build-up of scar tissue which goes back to (and I am no authority on this topic by any means) your body rejecting what was done down there.

I also wonder about what someone said in a prior reply about say issues stemming from things like contaminates in the environment or water. There is also proper hygiene (with no disrespect) that may have been a possible reason for the current issue.   

Hello All,

Well I got a reply from my surgeon:

"Dr. Sanguan advised:

You are not able to increase vaginal depth by dilation any longer.

For those considering Secondary Vaginoplasty, or redo the vaginal canal, there are two options.

The first choice is Colon Vaginoplasty using a section of the rectosigmoid or ascending colon which will provide a total of 6-8 inches vaginal depth. It is a good choice if the patient currently has at least 3-4 inches of vaginal depth and the vagina opening is wide and not tight. In this case, the junction of the colon and the previous vaginal skin would not be seen when the legs are opened. Also, there would be no constriction at the junction which can lead to difficult penetration. If the vagina opening or canal is very tight, a skin graft might be incorporated with the Colon Vaginoplasty.
         
The second option is a total skin graft Vaginoplasty. This method is suitable for the patient who has some redundant tummy skin. Then a tummy tuck will be considered to contour the patient's body and at the same time we can use the tummy skin to reconstruct the vagina, providing 5-6 inches of vaginal depth. Alternatively, if there is any other part of the body from which we can harvest the graft such as the waist, thighs or groin, we might use that skin.
           
Secondary Colon Vaginoplasty requires 7-9 days hospitalisation and costs US$13,000, inclusive of surgeon and hospital fees, and transportation from and to Phuket International Airport. If additional skin grafts are necessary the fee is US$15,000

Skin graft vaginoplasty with tummy tuck costs US$10,000 and involvers 9-11 days hospitalisation.

Skin graft Vaginoplasty, using skin from other parts of the body costs US$8,000 with 7-9 days hospitalisation.
             
Labiaplasty and Urethroplasty are procedures aimed at improving the external appearance of the genitalia and involve the removal of excess spongy Bulbospongiosus tissue from around the urethra. Labiaplasty costs US$4,000 and Urethroplasty costs US$3,000."

At least I now know that if I went back to see him, this is what I'd be facing, and the costs. I must admit they have gone up a lot in the past 13 years!
As to which type of surgery I should go for out of his options above, well I just don't know how to decide.
I don't have much "redundant tummy skin", so I guess that any operation would take skin from thighs or somesuch area, meaning a large skin graft scar visible on my body, which I must admit does not appeal at all.
I guess that I'd probably elect to have some kind of Labiaplasty as well, as my genitalia is not symmetrical at all, one side 'hangs down' much further than the other, it's pretty nasty actually, as that causes the inner sensitive area of the labia on the lower side to be exposed, and causes more painful rubbing. I wanted to feel proud of my vagina, but to be honest it's more of a disaster site. Another reason not to want to rush back to Thailand, or even to rush back into any kind of surgery, anywhere, really.

@Dena, I know what you mean about disconnecting from the TG community after surgery. I did the same, for 12 years.
This site is full of information, you are right. And I have been reading through it. Thanks for the link to the gender correction area, I will look there too.
One thing I struggle to find is if you are looking at a number of different surgeons, which one should you pick. Although I guess this is one of those moot questions, like which brand of car should you choose? They all have their pro's and con's, and advocates and critics. None are perfect.
By the way, I was joking about the plaster cast bit! I wouldn't embarrass my fella in that way. But I would certainly look for a dilator that was around his size, for sure.
My posts jump up and down in mood, just like me really.

@Jenna, thank you, as you and Dena suggested, I will keep looking through this site.

@Karen, thanks for the reply. I really do think that my body has rejected what was done to it, and it has responded badly to the changes I had hoped for. I will look up Vaginal Stenosis, although I think it's more to do with leftover erectile tissue. But of course it may be both, or neither of those. If I had been given the choice of changing my brain to match my body, or changing my body to match my brain, (knowing what I know now) I would choose the former over the latter, as my body really really wants to stay as a guy, no matter what I may want in my head
I guess I will never know if I was or wasn't hygienic enough all those years ago, not much I can do about that now.
But my main thoughts are that if I subjected my body to more (invasive) surgery, it may just be as difficult and un-co-operative as it was before. And I'd just be signing up to more debt, pain, and ultimately, failure?

At least I now have food for thought, and somewhere to go and read more.

Thank you for all your kind help,

V.