Thanks for another good report. Sounds like you are making good progess with your recovery.  I am interested in your progess in voiding, as I would really like to be able to void standing at an urinal.  I use the men's room almost always now and hate having to use a stall, seeing all the guys using the urinals is a real dysphia for me.  I want to be like all the other guys I see when I pee.

Post-Op: Six Month Summary

Whoa, time has flown.  I really did mean to keep up with doing an update at least once a month, but things didn't work out that way.  For starters, after the 2-month point, I began feeling well enough that there really wasn't much to report (for those wondering, if I had a desk job, I could have gone back to it).  Also around this time, I was having a hard time accepting my results for what they were.  The loose skin left by swelling and the fat and extra skin courtesy of a puffy mons covered up my penis to the point that it looked like I had a just a small head poking out from a sac or even from between two swollen labia.  Not really what I was hoping for, result-wise; it sent me for a head trip.  It was best that I just stopped obsessing about my dick for a while, and that included stopping the updates and photographs.  Anyways, to the very brief rundown:

Pain:
-Usually totally pain-free
-Occasionally, my right testicle will ache if something is pressing on it, but the ache goes away as soon as the pressure is removed

Mobility:
-I am back to normal mobility: walking, running, sitting any way I want, driving, laying any way I want
-I have not tried riding a bike yet (too snowy outside)

Voiding:
-Voiding is back to normal (apart from the change in urethra location, of course)

Healing:
-buccal mucosal graft is still smoothing out, but I only notice it if I think about it; the area is a little numb to the touch, but nothing bothersome
-I would consider myself 98% healed
-The 2% accounts for the occasional testicle soreness and lingering hard patches at the rear of both testicles
-I am still pumping 3x/day for 10-15 minutes (or alternately 1x/day with the cylinder locked on for 30 minutes straight if I don't have the time for multiple sessions--I don't know if this is necessarily recommended, but sometimes it's all I can fit in) and using Cialis; retraction seems to have resolved

Other:
-I can wear tight jeans with no discomfort

I know voiding is a big thing post-op, so here's where I'm at with it.  Since 2 months, I have been trying to void standing up at both a toilet and a urinal.  Sometimes it is successful, sometimes it isn't.  Since 2 months, my stream has gotten more predictable (less of a spray, more of a stream), but it still veers sharply right sometimes.  This especially happens if the stream is weak, when I don't have to go very much, or towards the end of going.  So what basically happens is that I can successfully pee through my fly (both boxer briefs/boxers and jeans) for everything except the very end, when the stream (sometimes) shoots to the right and (sometimes) leaves a wet streak on my right leg.  Obviously, 'sometimes' is not acceptable for being in public, so I sit if I'm out and about.  Unfortunately, the bathrooms at home are carpeted so 'sometimes' isn't really acceptable there, either.  In short, I've been making peace with sitting for now.  With sitting, it is also easier to get that last little bit out of my urethra by pushing up and forward from behind my balls.  If I do not do this, there will be a little bit of urine left in my urethra that will drain out as I walk or the next time I sit down (not cool).  So that is unfortunate but not totally unexpected.  Maybe I will be able to pee standing some day, it really depends on if my stream becomes more predictable as I heal further.  Additionally, pumping makes my stream more unpredictable and can even turn it into a spray again; I think this is due to the tissue swelling that pumping causes.

Another note: urinals are easier to use than toilets when standing up.  I think this is because my penis points straight forward on its own.  If I'm trying a toilet, I need to know where the stream arc is going to end up (I almost always miss at first) or try to point my penis down, but that's hard because my hands are busy pushing the underwear/jeans flies out of the way and pushing fat back to expose my penis.  As for sitting techniques, for the first few months (when it hurt to manipulate my penis), I sat far back on the seat and leaned forward to get the stream to go in the bowl instead of over the top of the rim.  Now, I'm able to just grab it and point it down, which is cool.  I can control where it goes and can play target practice with stains on the porcelain if so inclined.

I don't have any real issues with the urethra: no fistulas, no strictures, and for that I'm thankful.

So back to my thoughts on visual results.  I think my balls look fantastic.  The placement is ideal, they aren't in the way like I thought they would be (though I will occasionally 'pinch' one doing some activities, but they're kinda squishy and don't hurt).  They are plenty visible from all angles and just generally look good to me.  I was fortunate to have had "large, floppy labia" (Miro's words), so wandering implants resulting from insufficient scrotal space are not a problem for me; I did not need tissue expanders.  My scrotum is not fused, so there is a deeper cleft than factory-issue scrotums tend to have, but it's OK for now.  I will probably have it fused in the future.  My penis... looks great when the fat and extra skin are pushed back.  I gained a little bit of length and can now pump out to 2.5" as opposed to 2" prior to surgery.  I can actually see my head when not pushing any skin out of the way; prior to surgery, it could not be seen at all from the front and was really buried.  But I think I would really benefit (cosmetically) from mons liposuction, trimming of the extra skin around my penis, and a mons resection to lift everything up higher.  Marta said that I was of average size (for a meta) and that my biggest problem was the mons fat and I believe her.  So yeah, losing weight for starters and then I'll start looking into a revision later down the road.

I sincerely doubt my penis would be useful for penetration, but I don't care.  I always wondered if my lack of interest in relationships and sex was because of my body, but that doesn't seem to stop a lot of other trans people.  As for comfort levels, at 2 months post-op I was running around on a beach, naked except for small boxers and quite comfortable; if my penis was less buried and more defined, I think I'd be fine with a nude beach, small and all.  At this point I think I'm just not a particularly sexually driven person, rather than body shy or uncomfortable in my skin.  I have tried it out, though, and orgasms are fine.  Whatever nerves control that were not at all damaged during surgery.  I do have a numb spot right above my penis where the ligaments were severed and the sensation on my sac is pretty patchy--it sort of feels like my chest did after peri, though the chest sensation did mostly come back after several months/years.

So, in all, things are pretty good, even if I am going to be seeking revision to address the extra mons fat/skin, hopefully improve shaft prominence, and fuse the scrotum.  And I just realized that in a few days I'm going to be 3 years on T... again, how time flies.

Quote from: mm on October 18, 2011, 03:56:45 PM
Thanks for another good report. Sounds like you are making good progess with your recovery.  I am interested in your progess in voiding, as I would really like to be able to void standing at an urinal.  I use the men's room almost always now and hate having to use a stall, seeing all the guys using the urinals is a real dysphia for me.  I want to be like all the other guys I see when I pee.

Sorry for the long delay before I saw this.  Hope my latest entry answers your question at least in part, mm.

Glad you finally posted an update.  I was wondering about you the other day.  Glad to know things are going good.

I am 18 months post-op and my stream still occasionally sprays at an odd angle or gets on my pants.  It definitely helps to have a really full bladder to help get a good strong stream.  I mostly sit, but lately have been standing more.  Did get a good drip on my pants at work; thank g*d for black jeans so it didn't really show.  Urinals are easier as they catch the spray when it veers.  Not sure why it sprays more sometimes vs others.    Most men have post-pee drips, which is why they shake it, so I'm not really concerned about that.


Jay

I just recently read the entire account so far - thanks for posting. Meta is what I'm going for, and it really helps to hear first hand accounts. Little details are important in gauging how my own experience is going to be. And as mm said, it seems like recovery is going really well despite the few residual issues.

Quote from: Andy8715 on January 22, 2012, 11:35:25 PM
Glad you finally posted an update.  I was wondering about you the other day.  Glad to know things are going good.

Yeah... I felt kinda bad having a 3-4 month gap in updates, even if there wasn't much to say.  The next time I update will probably be when/if I have something more to say about voiding or whenever those hard spots at the back of the implants finally soften.  Beyond that, I'm having a pretty good time just getting on with life.

Quote from: sneakersjay on January 23, 2012, 08:05:10 AM
I am 18 months post-op and my stream still occasionally sprays at an odd angle or gets on my pants.  It definitely helps to have a really full bladder to help get a good strong stream.  I mostly sit, but lately have been standing more.  Did get a good drip on my pants at work; thank g*d for black jeans so it didn't really show.  Urinals are easier as they catch the spray when it veers.  Not sure why it sprays more sometimes vs others.    Most men have post-pee drips, which is why they shake it, so I'm not really concerned about that.


Jay

Yeah, black pants are a good thing.  Most of the pants I have are dark-colored, anyways.  I've also found that long, straight flies are easier to work with than the short flies on skinny jeans (they're OK, but I need to pull them down about 2" for the fly to be in ideal position).  That's true about urinals, they're much better for catching a veering stream than toilets.  And I now have some understanding of guys who leave droplets all over the seat (or even on the floor) in public restrooms.  When I was using my STP pre-op, I used to wonder why guys found it so difficult to aim properly... well, I think I know, now.  An STP with a perfectly smooth, round, manufactured tube results in a highly predictable stream.  Surgery, obviously not so much, but I have to wonder about the predictability of factory-issue streams, too.

As for my stream veering right, I did notice that my urethral exit is not perfectly circular (obviously--it's not for anyone, I don't think).  It is a vertical slit that stretches from the middle to the bottom of my glans, but I think the problem lies in the fact that there is an indentation or a fold of skin on one side of the slit (the right side, surprise surprise, same side that the stream veers).  And I have more problems with spraying if I've pumped recently, as I said, but I also have problems with spraying if my foreskin gets too close to my stream.

Quote from: Caseyyy on January 23, 2012, 09:55:45 AM
I just recently read the entire account so far - thanks for posting. Meta is what I'm going for, and it really helps to hear first hand accounts. Little details are important in gauging how my own experience is going to be. And as mm said, it seems like recovery is going really well despite the few residual issues.

You're welcome, glad it's useful.  I've gotta say, in the absence of major problems (mostly the possible urethral complications), the little issues have started to seem bigger to me.  But I think that being aware of even the little details, good and bad, is important before deciding on surgery.  The fewer surprises with something like this, the better--though of course everybody heals differently.

I just realized I don't think I've ever posted in this thread.  Thanks so much for taking the time to write all of this, gaps and all.  As someone who is still on the fence about bottom surgery, this is extremely helpful.

Re: urine stream, I think I remember reading about a guy who self-cathed with progressively larger catheters in order to get a better stream.  He also had no complications IIRC.  Maybe something to think about and discuss with either Miro and/or a urologist. 

My urethra is more of a mercedes benz logo shape slit with upside-down V (ie tiny flap at the bottom).

I also found that boxer brief flies are more forgiving than trying to lower the elastic waistband of briefs.


Jay

Thanks for the detailed info Ender. 

Ender, this is an amazing thread.  I don't know if you will ever see this post, but I just wanted to say I am blown away by the time you took to write this.  i will be going to Crane for meta in 3/2016 and when I hit the search key to find a thread like this I really doubted I would find anything of significance.  Your goal of having a thread that a guy in the future would very much appreciate was indeed met.  Thank you so much!

P.S. Any updates?

Quote from: Bimmer Guy on June 27, 2015, 06:17:42 PM
i will be going to Crane for meta in 3/2016

Oh, boy. When did you book the appointment? I don't know how far in advance he is scheduling, but I thought that I should probably get a consultation about a year and a half in advance of my first procedure because I am shooting for summer 2017 and need to book the surgery during a very narrow window of about one week in June. If I can't get it done then, I will have to wait another year.

I guess I have a little time to get my act together. But still...

Quote from: Arch on June 27, 2015, 10:22:43 PM
Oh, boy. When did you book the appointment? I don't know how far in advance he is scheduling, but I thought that I should probably get a consultation about a year and a half in advance of my first procedure because I am shooting for summer 2017 and need to book the surgery during a very narrow window of about one week in June. If I can't get it done then, I will have to wait another year.

I guess I have a little time to get my act together. But still...

It was only 3 weeks ago, but I am getting the surgery in Austin, so he just started scheduling there.  If I wanted to schedule with him in CA, it would be an additional 7 months wait (which would mean a 16 month wait total).

I knew for certain that I wanted Crane so I would have waited as long as needed.  If you know you want him, no downside to calling now to see if they will schedule out that far.  The only benefit I see to waiting is if you want to see if new techniques come out that another surgeon does that you may find you like better.  A LOT can change in two years.

Your other option is to schedule with Crane now, and cancel later.  You will lose the $1,000 scheduling fee, though.

Good luck to you, Arch.  I know you have waited a long time to be able to get this surgery.

Bimmer, I don't have an academic calendar for that far in advance, and one of my schools is supposedly going to a new academic calendar by then. If it does, I might have to schedule further out because I'll be grading work from two schools at once instead of the usual one. Sheesh, who knows when I'll have all of this sorted out. Sometimes I wish I had a regular job; I would simply take medical leave.

Looks like I'll have to sit tight and wait to see what happens. But I can definitely get in touch with Crane's office and see when he expects to be in CA that year. D'you suppose they would know that two years in advance? Guess I'll find out.

I haven't even scheduled hysto yet, mainly because I'm stressing out. Arranging bottom surgery is going to make me a nervous wreck.

Quote from: Arch on June 29, 2015, 03:11:50 AM
Bimmer, I don't have an academic calendar for that far in advance, and one of my schools is supposedly going to a new academic calendar by then. If it does, I might have to schedule further out because I'll be grading work from two schools at once instead of the usual one. Sheesh, who knows when I'll have all of this sorted out. Sometimes I wish I had a regular job; I would simply take medical leave.

Looks like I'll have to sit tight and wait to see what happens. But I can definitely get in touch with Crane's office and see when he expects to be in CA that year. D'you suppose they would know that two years in advance? Guess I'll find out.

I haven't even scheduled hysto yet, mainly because I'm stressing out. Arranging bottom surgery is going to make me a nervous wreck.

Arch, somehow I missed this and you might have your answers by now.  Crane's plan is to travel to SF quarterly for two weeks each time.  This is already in place for 2016.  Perhaps this will become his standard schedule. 

You can get your hysto done during your bottom surgery with Crane.  All in one shot.  That is not uncommon for guys to do.  He does not do the hysto, but works with a GYN surgeon who comes in.

Thanks for bumping this! I'd read through the links to external sites that were posted in the past, but it was nice to see a day by day account of the experience in Serbia and coming home. Hadn't seen this on here before.

I've been really torn lately about which procedure I truly want, but I'm settled on Dr. Miro and this has been so helpful.

Quote from: ftmax on August 01, 2015, 01:43:02 PM
Thanks for bumping this! I'd read through the links to external sites that were posted in the past, but it was nice to see a day by day account of the experience in Serbia and coming home. Hadn't seen this on here before.

I've been really torn lately about which procedure I truly want, but I'm settled on Dr. Miro and this has been so helpful.

hey, ftmax.  I know you were thinking about Miro and Crane.  I am wondering if you get trans health insurance if you are still set on Miro? 

There is a big difference in the way that Crane does the scrotum in the meta.  Crane fuses the scrotum at the mid line, rather than just placing the testicular implants into each labia majora.  Too, he places the scrotum in a more anterior position.  However, you do have to have two surgeries if you go with his approach.  He creates the scrotum at the first surgery and then you go back 6 months later for the testicular implants.  Some guys don't even bother with the implants because they feel that they already have a full enough scrotum.

Crane does a vaginectomy which results in complete closing of the vaginal cavity, making it look the same as any male perineum.  Miro does a colpocleisis, so there needs to be a small drainage hole left.

You may already know all of this, but I just wanted to highlight it for you if you are considering meta.  I don't know what differences there would be if any (besides the vaginectomy vs. colpocleisis) for their phallos.

If I have any of the above wrong (about miro's surgery), I hope someone comes in to correct me.

If I got better insurance, I'd definitely be open to Crane.  It seems doubtful at this point though, unless I'm willing to move and that won't happen for another year (my only real hope of changing insurance around here is if I get a government job, and I'm not a veteran in an area that caters to people who already have clearances). And if I have to go out of pocket, Miro is a fraction of Crane even if we include all the travel. Still, gives me more time to think about things.

I've been leaning more towards phallo for the last few months. Top surgery made life a lot better, but now I'm focused downstairs 24/7 and so abysmally unhappy. Based on what Crane has online, I prefer Miro's aesthetics. I'd have to email Crane's office though before I was 100% sure - he doesn't have any pictures in his gallery of guys that used the MLD donor site, which I'm most interested in.

Makes sense, ftmax (your entire post).

I suspect he doesn't have any MLD posts because he never recommends them.  So, perhaps he doesn't do many of them? 

You are aware the issue is it is about how MLD uses a motor nerve rather than a ? nerve?  I don't know all that much about it since my focus has been in meta.  However, my understanding is that the sensation is quite different and more muted, so to speak, with the MLD.  Crane always recommends RFF.  ALT is the other wone he does on a regular basis.

Yeah, that interested me because both of the surgeons in Serbia I've looked at do MLD exclusively based on the results I've found. I'm not sure if it's just skin quality at the donor site or what, but aesthetics wise everything looks much better to me.

I hadn't heard that that was the case with sensation, so I'll read up on it. Sensation isn't in my top five of most important qualities though, so it's not a deal breaker if that is the case.