Hi MedusaIt sounds like you had a really solid consult and it's good they were upfront about what they can and can't guarantee. That alone would give me some confidence in them.
I'm not very familiar with the peritoneal pull through approach, especially for revisions, so I can't really speak to the finer details of that technique. But from what I understand it's being used more now in both trans and cis cases where depth is limited, so you're definitely not alone in looking at that option.
If you are comfortable sharing, it might help to understand your situation a bit more. What sort of depth do you have at the moment and was it limited from the start or did it change over time? Also do you know what technique was used in your first surgery?
I was also wondering about the recovery side of things. At first I thought this approach might be a bit easier than a traditional inversion but then I realised it also involves abdominal surgery as well as the vaginal side and in your case it's a revision on top of that. So I'm not sure it actually ends up being any less demanding overall.
From what I've seen generally recovery from revision work can take time and dilation seems to be a big part of things especially in the first year. The longer term routine seems to vary a lot person to person despite what surgeons recommend.
I have also seen that when depth is limited there tends to be a few different revision pathways people look at, like skin graft based revisions, intestinal approaches and now peritoneal pull through and it seems to come down a lot to individual circumstances and what the surgeon is comfortable with.
I should also say my own experience was probably a bit different. I had my surgery back in February 1991 and to be honest dilation was not really discussed in the structured way it seems to be now.
What I did use was a soft foam stent with a condom over it and I would leave it in for extended periods rather than doing short repeated sessions. I honestly do not even remember how often I did it, it was not something I was tracking closely. I never found it painful and I also had normal sexual function which helped maintain things over time.
That said I suspect that depends a lot on the initial outcome and healing and in a revision situation like yours it could be quite different. So I would not assume the same approach would apply but it might be interesting to see how others have found it with this particular technique.
I have also come across more discussion of PPT for revision on some of the larger trans discussion spaces online particularly where people share more recent surgical experiences so it might be worth looking around a bit more broadly as well.
As to how you proceed it's really a personal decision and only you can decide what feels right for you but taking a bit of time to look into the different options and hear from others who have been through it might make the decision feel a bit easier.
Take care and all the best for the future and let us know how you go.
Best Wishes AlwaysSarah BGlobal Moderator@Medusa
