Vulvoplasty?

[Vini]

Hi Hannah,  I'm no expert, just a preop trans trying to figure it all out too.  But from what I understand, you don't need any hair removal for Vulvoplasty.  ohsu.edu/transgender-health  has a lot of good info on the surgeries.  Vulvoplasty is covered in their Vaginoplasty Booklet, including Hair Removal.  I think it says you can leave the hospital  in three days after a vulvoplasty with another week of rest at home under care,

 

I haven't found much about Preop Hair Removal for Vaginoplasty.  If anyone has any advice, I would be glad to hear from you.  Thanks and good luck, Vini

[Trans22]

The idea of dilating while healing really scares me, so I was thinking about a vulvoplasty.  Better information here, in terms of information I am after, than anything I found online.  The recovery times really scare me, but the cost will probably be what stops me.  If you are live in Australia and know an insurer that will cover GCS/GRS/SRS, I'd love to hear from you.  I'm only 2.5 months into HRT, so surgery options are at least 2 years away according to my gender psychiatrist.

[Danyczer]

On 9/28/2021 at 1:09 PM, KathyLauren said:

I went with a "no cavity" vaginoplasty, a.k.a. "zero depth", a.k.a. vulvoplasty, etc.  It is not actually zero depth: I have a dimple about 3/4 of an inch deep where a vagina would be, so it doesn't look too weird on a quick glance.

 

I knew that there was no chance that I would ever want a penis anywhere near me (I find them, and often their owners, repulsive), so I had no need for a vagina.  Yes, girls sometimes play with toys, but my wife and I don't have much libido left, and she was never into toys.

 

With no compelling reason to have a vagina, I could not see any reason to put up with months of full-time dilation, years of daily dilation, and a lifetime of ongoing dilation.

 

I have no regrets about that decision.  What the surgeon gave me looks quite realistic.  It would require a very close inspection to see that it was not a cisgender vulva. 

 

I have other issues with ongoing pain and discomfort that make me question the wisdom of having GCS at all.  But that is not related to the full-depth versus shallow-depth decision.  On the whole, I am glad I had it, and I am very happy with my decision on the type of surgery.  Mine is just a b***h to live with.  So be sure you really want it before going ahead.

 

Can you please tell me more information about your complications and what type of pain and discomfort do you have? Where? How does it feel? Because I’m thinking about doing vulvoplasty to avoid those kinda complications. Are your pains and discomfort related to the pelvic floor? I read that with vaginoplasty, creating a canal that should not be there can damage the nerves of your pelvic floor. I thought that could be avoided with vulvoplasty because there is no vaginal canal, but when I read your post I was so disappointed, I thought that I could choose that option and avoid all those crazy complications after vaginoplasty. I don’t know what to do then  

 

If it’s not so much to ask, how are your orgasms and sexual pleasure after? Thank you and sorry for bothering. 

[Carolyn Marie]

1 hour ago, Danyczer said:

If it’s not so much to ask, how are your orgasms and sexual pleasure after? Thank you and sorry for bothering. 

 

Please remember to keep any answers within the bounds of our Community Rules.  Or send the info via PM.  Thank you.

 

Carolyn Marie

[KathyLauren]

6 hours ago, Danyczer said:

 

Can you please tell me more information about your complications and what type of pain and discomfort do you have? Where? How does it feel? Because I’m thinking about doing vulvoplasty to avoid those kinda complications. Are your pains and discomfort related to the pelvic floor? I read that with vaginoplasty, creating a canal that should not be there can damage the nerves of your pelvic floor. I thought that could be avoided with vulvoplasty because there is no vaginal canal, but when I read your post I was so disappointed, I thought that I could choose that option and avoid all those crazy complications after vaginoplasty. I don’t know what to do then  

 

If it’s not so much to ask, how are your orgasms and sexual pleasure after? Thank you and sorry for bothering. 

 

 

First of all, my experience is not typical.  My surgeon was one of the top GCS surgeons in the world - he trained most of the other surgeons in North America - so he knew what he was doing.  My body just seems to have reacted in an atypical manner.

 

My problems consisted mostly of ongoing pain and discomfort.  After months of working on it, it seems that most of the pains were associated with scar tissue.  My pelvic floor physiotherapist has helped me work on massaging the scar tissue to help break it down, and that is slowly working.  Mostly it is not painful any more. 

 

The discomfort takes the form of pressure.  It feels like the area, especially the clitoris, is wrapped tightly in duct tape and bandages.  That, too, is gradually reducing, with help from my physio.  If I am just going about my daily business, I would rather not be aware of my vulva.  So far, that has not been an option.  It kind of forces itself into my awareness.  It is just always there, seeking attention.

 

I think I can safely answer your last question without violating @Carolyn Marie's guidelines.  There is basically nothing to report.  It is hard to feel erotic when the area is a source of pain and discomfort.  Lately, the discomfort has reduced to the point where the prospect of playing a bit is plausible, but it hasn't happened yet.

[VickySGV]

24 minutes ago, Hannah Renee said:

Are the services of a pelvic floor physiotherapist generally a necessary thing post-op and beyond?

 

I am ten years post op and it was never an issue to me.  Yes, healing in my case took nearly 18 months for me to say it was complete, but 8.5 years that it has been resolved, life if just life.  Every person is so different that it simply is not possible to say what treatment you will need.  Go to the Post Surgery Forum and go to posts there that I made during my adventure, some are actually pretty funny and light as the new experiences happened.  Yes there are problems that are uncomfortable and some people declare that things "MUST" happen their way, but their way is theirs and you will have enough of your own healing that is a bit rough that you need to leave their problems be.   About 4 or 5 of us had our surgeries at the time and stayed here to talk about them so we are rich that way.  The posts are all from 2013 and 2014.

 

[KathyLauren]

17 minutes ago, Hannah Renee said:

@KathyLaurenAre the services of a pelvic floor physiotherapist generally a necessary thing post-op and beyond?

 

I do not know.  There was nothing about pelvic floor physio in the pre-op literature from my surgeon, and I had never heard other trans folks talk about it.  In fact, I didn't even know it was a thing until long after my surgery.  I complained to my surgeon about my problems and he told me that I should be seeing a pelvic floor physio.  He was like, "Duh!  Everyone should know that."  I had never heard of such a thing.

 

It does seem to be helping.  So I would think that being well-prepared for every eventuality before surgery would include researching pelvic floor physios.  Talk to the doctor who signs off on your paperwork for surgery to see if they recommend any pysios with trans experience.  You might not need one, but if you do, you do.

 

Trans experience is crucial.  I did find one pelvic floor physio in my area, about a 30 minute drive away.  But she had never seen a trans client, had no idea of trans female post-op anatomy, and had no idea on how to proceed.  I finally tracked down one and hour and 45 minutes away with the necessary experience.  She is really good!

[Danyczer]

2 hours ago, KathyLauren said:

 

 

First of all, my experience is not typical.  My surgeon was one of the top GCS surgeons in the world - he trained most of the other surgeons in North America - so he knew what he was doing.  My body just seems to have reacted in an atypical manner.

 

My problems consisted mostly of ongoing pain and discomfort.  After months of working on it, it seems that most of the pains were associated with scar tissue.  My pelvic floor physiotherapist has helped me work on massaging the scar tissue to help break it down, and that is slowly working.  Mostly it is not painful any more. 

 

The discomfort takes the form of pressure.  It feels like the area, especially the clitoris, is wrapped tightly in duct tape and bandages.  That, too, is gradually reducing, with help from my physio.  If I am just going about my daily business, I would rather not be aware of my vulva.  So far, that has not been an option.  It kind of forces itself into my awareness.  It is just always there, seeking attention.

 

I think I can safely answer your last question without violating @Carolyn Marie's guidelines.  There is basically nothing to report.  It is hard to feel erotic when the area is a source of pain and discomfort.  Lately, the discomfort has reduced to the point where the prospect of playing a bit is plausible, but it hasn't happened yet.

Thank you so much for your answer! And again, I’m really sorry if I made an uncomfortable question. So if you are going with a pelvic floor physiotherapist then the scar tissue is exactly the problem or maybe the surgery kinda damaged the nerves of your pelvic floor? And that would be weird, since in your case, no vaginal canal was done inside so no nerves should have been damaged. 
 

Your case might be weird but is a reality that doctors usually don’t know or don’t tell about. You may disagree, but in my opinion gender confirmation surgery is still highly experimental. Even after more than one hundred years since they made the first vaginoplasty, they don’t know about the complications for short and long time (there are trans woman who present the symptoms of lifelong complications after like two years of the surgery, even after everything went well at the beginning) I have my theories about why they haven’t done more investigation about it but it’s a complicated topic I guess 😅😅😅😅
 

I thought that zero depth vaginoplasty or vulvoplasty could be a better option for me since I’m super scared of the complications of a full vaginoplasty, but it seems there are still some risks. I guess I’ll just think about it and see which options are best for me or what I am gonna do about it 

 

Thank you again ❤️
 

[Danyczer]

1 hour ago, KathyLauren said:

 

I do not know.  There was nothing about pelvic floor physio in the pre-op literature from my surgeon, and I had never heard other trans folks talk about it.  In fact, I didn't even know it was a thing until long after my surgery.  I complained to my surgeon about my problems and he told me that I should be seeing a pelvic floor physio.  He was like, "Duh!  Everyone should know that."  I had never heard of such a thing.

 

It does seem to be helping.  So I would think that being well-prepared for every eventuality before surgery would include researching pelvic floor physios.  Talk to the doctor who signs off on your paperwork for surgery to see if they recommend any pysios with trans experience.  You might not need one, but if you do, you do.

 

Trans experience is crucial.  I did find one pelvic floor physio in my area, about a 30 minute drive away.  But she had never seen a trans client, had no idea of trans female post-op anatomy, and had no idea on how to proceed.  I finally tracked down one and hour and 45 minutes away with the necessary experience.  She is really good!

That is my point! He didn’t tell you and no doctor tell you that. You couldn’t have known that information, he’s the professional and he’s the one who should have told you before the surgery was made. I do know some trans women who have lifelong complications with the pelvic floor (they have pain as well). And they had the same experience, they weren’t informed of this and even with the best surgeons from Thaliand to United States and Europe, they all told them that they didn’t know why they had those complications from the surgery. They basically washed their hands and told them that maybe it was their fault because “they dilated badly” or stuff like that. They literally had to search for their own physiotherapist and waste a LOT of money just to improve their quality of life, but sadly, is apparently permanent.
 

One trans woman in particular (here in Spain), she started feeling a lot of pain after two years being post op of a full vaginoplasty (two years before, when she was newly operated, everything went well, even with her dilations, and the canal didn’t close). Also, two years after, her urethra started closing and she needed a second surgery to correct that. The pain left for some time but came again. The doctors did tests and they told her that she was fine, but the pain was still there. They told her that it was probably her fault (even without explaining to her why it should be her fault). Then she went to an urologist who confirmed her that opening up a vaginal canal that shouldn’t be there in the first place can damage the nerves of your pelvic floor apparently permanently. She tried to contact again her doctor, and like six years after they haven’t answered her emails and forms of communications. They basically left her alone. There are a lot of trans woman with this experience, and they don’t speak about it for a number of other reasons, but they exist, and I think is so sad that after having such an invasive and hard surgery for the well being of your dysphoria then you have these complications and the doctors make you feel responsible for them. That’s why I’m so scared of having a full vaginoplasty.
 

But anyway, as the urologist of the spaniard trans woman that I told you before said, the nerves of the pelvic floor can be damaged because of the new created canal. So, it’s really weird that in your case, in which you didn’t have any vaginal canal created, have these complications. So apparently a vulvoplasty with zero depth can have this complications as well? I hope not, and I hope is not your case. 
 

I’m sorry, I don’t want to make any of you feel guilty about your surgeries and all, but I think is the best for our own well being to be honest with how these surgeries really are and how often the surgeons leave these trans women alone. And also, doctors should investigate more and tell us the complications that they probably know but don’t want to tell. At least, if we are going to pass through this surgery, we should do it well informed by them. That’s my opinion. 
 

I really wish you the best and I hope that you can resolve entirely your problem with your physio. I send you my best energies ❤️❤️✨💕💕

[Heather Nicole]

2 hours ago, KathyLauren said:

I do not know.  There was nothing about pelvic floor physio in the pre-op literature from my surgeon, and I had never heard other trans folks talk about it.  In fact, I didn't even know it was a thing until long after my surgery.  I complained to my surgeon about my problems and he told me that I should be seeing a pelvic floor physio.  He was like, "Duh!  Everyone should know that."  I had never heard of such a thing.

 

I don't consider myself to know, or have been around, a particularly large number of trans people (and I'm pre-op myself), but FWIW, I've only heard of one other post-op trans woman aside from @KathyLauren here who needed pelvic floor help. (BTW, Kathy, I'm glad to hear it's at least been improving for you! I saw your other posts about it and was hoping things would improve.)

 

This other one is a YouTuber, and has at least a couple videos posted where she talks about it. I don't think our rules here would allow me to link directly to the specific videos, but they're somewhat older ones by Coach Jamie ("TheTransCoachJamie"). Basically what she was saying (if I understood right), is that she discovered she tends to store stress in her pelvic floor muscles, and that made dilating difficult and painful until a specialist helped her learn to address the pelvic floor muscle tension.

 

Not trying to scare or discourage anyone, of course. I just thought it seemed relevant to what @VickySGV said about how sometimes things can just be very individual. And also that, if seeing a pelvic floor physio post-op is typical, then that would be news to me, too (for whatever little that may be worth coming from me!)

 

 

[gracey]

On 5/22/2022 at 4:01 AM, Vini said:

Hi Hannah,  I'm no expert, just a preop trans trying to figure it all out too.  But from what I understand, you don't need any hair removal for Vulvoplasty.  ohsu.edu/transgender-health  has a lot of good info on the surgeries.  Vulvoplasty is covered in their Vaginoplasty Booklet, including Hair Removal.  I think it says you can leave the hospital  in three days after a vulvoplasty with another week of rest at home under care,

 

I haven't found much about Preop Hair Removal for Vaginoplasty.  If anyone has any advice, I would be glad to hear from you.  Thanks and good luck, Vini

👆🏼This matches my understanding (I'm in the same position as Vini—planning and researching myself). However, I do think it is a little dependent on the surgeon. Mine was clear this wasn't required (I'd started electrolysis prior to my surgeon appointment as I hadn't fully decided which way I was going, and he said I didn't need to continue).

[missyjo]

there's another threading called cosmétic vagino n it sounds like good insight into the zero drpth vago.

 

as to shrinking the junk..I'm looking into orchi to keep scrotum for vaginopmasty in 2 years n get a smaller smoother mire femme crotch until then. just a thought

 

hugs

missy jo 

[missyjo]

Hannah Renee

 

thank you darling 

any insight helps make it less scary. thank you

 

hugs

missy jo