loss clitoris sensation risk

25
u/Susaop
Wed Sep 4 16:08:42 2019 UTC
(21 comments)

I'm sorry English isn't my native language (I'm from Italy ,where I want to do my surgery becouse here is covered by public health) so... I'm considering zero/low depth vaginoplasty. I'm not really into penetrative sex, all I want is to preserve clitoris sensation and capability to orgasm. I'm searching about rate risks to clitoris necrosis but I found discord informations (2% maybe?). I fear to loss my sensation capability after the surgery. Do you have some references? Thanks you all

all 21 comments



7
u/[deleted]
Wed Sep 4 20:54:02 2019 UTC
(5 children)

I found a great book chapter on vaginoasty complications. It says "Necrosis of the neoclirotis is, fortunately, uncommon. Most surgeons report an incidence of 1-3%, but rates as high as 10% were noted in one review series. Even in these cases, the outlook remains reasonably positive, as most patients can achieve orgasm with or without clitoral sensation."

Admittedly, that last part seems most relevant to folks not getting the minimal depth vaginoplasty.

6
u/Susaop
OP
Wed Sep 4 22:02:20 2019 UTC
(2 children)

Thanks! This is why I'm afraid about this risk: I don't like too much receiving penetrative sex (mentally) and I haven't experienced in my life prostate orgasm (I tried but isn't my way) . The minimal depth option is my goal, I would like to have the labia shape and enjoing sex with clitoris. But 1-3% (or 10%!) isn't really uncommon risk I think...it depends from point of view maybe 😅 I've found in an article that risk of clitoris necrosis is associated (not only) whith dilations (becouse it can cause clitoris nerve and veins compressions). Maybe whith minimal depth this risk is more uncommon...

7
Wed Sep 4 22:10:53 2019 UTC
(1 child)

Minimal depth option is my goal too! I think the number one thing to remember is that necrosis doesn't happen to a random 1-3% of people: it's much more likely to happen to folks with risk factors, so you should consider your specific situation. Here's another quote that might be helpful:

"Medical history (presence or absence of comorbidity) and nutritional status can also play a significant role in determining outcome and successful healing. Diabetes, while not a contraindication to GRS per se, is associated with greater risk for tissue necrosis. Selective debridement of tissues, wet-to- dry dressings, and “a tincture of time” are the best allies in treatment of these issues. Reopening of a portion of the incision and drainage is indicated for abscess but is rarely necessary. Pelvic and perineal circulation tends to be excellent and resilient, allowing many of these losses to ultimately resolve with such conservative management...When clitoral necrosis does occur, the necrosis is most often partial with neovascularization and some residual sensation possible. Finally, for the rare patient whose clitoris loses both blood supply and innervation, the other areas retaining erectile or erogenous sensation (spongiosum, G-spot, prostate, etc.) can provide enough stimuli to allow orgasm. If patients remain anorgasmic after 1 year, topical testosterone cream (1 % compounded) can be helpful."

Btw, chapter is Complications of MTF Vaginoplasty by Allison S. Glass and Marci L. Bowers. In Management of Gender Dysphoria https://books.scholarsportal.info/en/read?id=/ebooks/ebooks3/springer/2016-03-02/3/9788847056961

2
u/Susaop
OP
Thu Sep 5 09:08:51 2019 UTC
(0 children)

this is comforting thanks!

6
u/MeowMeowsBottomBitch
Wed Sep 4 23:18:17 2019 UTC
(4 children)

Sadly it's hard to get credible figures on that. It also varies a lot by surgeon!

Suporn can create a new clitoris if the original one was lost to necrosis because he preserves the rest of the glans in another location. But he does not do zero depth unfortunately.

With any surgeon, there is always the risk of sensation loss.

1
u/Susaop
OP
Thu Sep 5 09:04:14 2019 UTC
*
(3 children)

maybe it's possible ask to preserve the entire or the majority of glans (if this raise the possibility of sensitive success)? It's a strange thing to say?

3
Thu Sep 5 17:22:05 2019 UTC
(2 children)

That comes with other problems. Either there is the whole glans exposed (this will look very out of place) or it will be buried and flat.

There are a lot of different approaches, maybe you can find one that fits you.

1
u/Susaop
OP
Fri Sep 6 09:08:53 2019 UTC
(1 child)

Thanks! The glans exposed is an aesthetic problem or is also a functional problem?

2
Fri Sep 6 12:59:38 2019 UTC
(0 children)

Was merely an example, it all depends on the technique used and the surgeon's skill.

u/[deleted]
Wed Sep 4 16:14:10 2019 UTC
(4 children)

[deleted]

5
Wed Sep 4 20:41:10 2019 UTC
(1 child)

Can I ask who your surgeon was?

4
u/Susaop
OP
Wed Sep 4 22:03:05 2019 UTC
(0 children)

Thanks for the response! I'm glad you experienced that!

3
u/HiddenStill
Sun Sep 8 22:08:39 2019 UTC
(8 children)

Italy is not well known for this surgery. It's possible that the risks are very different to countries like the USA or Thailand.

3
u/Susaop
OP
Mon Sep 9 11:07:40 2019 UTC
(7 children)

There's an equipe in Pisa/Firenze that seems to work well, they do 3/4 surgery a month. But yes, I have only anecdotal reports.

3
Mon Sep 9 16:35:56 2019 UTC
(6 children)

Do you have any links I could add to the wiki?

2
u/Susaop
OP
Mon Sep 9 20:01:22 2019 UTC
*
(5 children)

I've done a research, I found poor links. No images, because in Italy you can't find surgeries images in the official hospital sites. The most interesting is this PubMed article (that seems what I'm searching for about clitoris sensation): https://www.ncbi.nlm.nih.gov/pubmed/31266281 . Most of the autors are Pisa/Firenze surgeons equipe: Girolamo Morelli, Augusto delle Rose, Andrea Cocci, Simone Caroassai, Valeria Matteucci. I haven't access at the full article, you can help me? Here another PubMed article (not very interesting I think): https://www.ncbi.nlm.nih.gov/pubmed/31144492 .Here another link (but in italian), they are poor slides about the gender affirming treatment in these hospital in Pisa and Firenze: https://www.fondazionethebridge.it/wp-content/uploads/2018/05/Girolamo-Morelli.pdf . This is the link to the hospital site: https://www.ao-pisa.toscana.it/index.php?option=com_content&view=article&id=229:uo-urologia-2&catid=106&showall=1&Itemid=113 . I'm sorry for my bad english.

3
Mon Sep 9 20:19:28 2019 UTC
(2 children)

Thanks. For papers take a look at this sub

https://www.reddit.com/r/scihub/

2
u/Susaop
OP
Wed Sep 11 19:44:34 2019 UTC
*
(1 child)

/u/HiddenStill I found the link where it's possible to download (for free) the full paper PDF "male to female gender affirming surgery: modified surgical approach for the glans reconfiguration in the neoclitoris (M-shape neoclitorolabioplasty)". Obviously it's NSFW, there are many surgery pics. It's a study of many surgeons from Firenze/Pisa/Trieste (Firenze and Pisa are two hospitals that at the moment works together, they have the same waiting list for vaginoplasty and works with the same equipe). There are also the statistics I'm searching for. I think you can add this to the Wiki. https://pagepressjournals.org/index.php/aiua/article/view/aiua.2019.2.119

1
Wed Sep 11 20:00:03 2019 UTC
(0 children)

Thanks, I'll take look.

2
Mon Sep 9 20:23:34 2019 UTC
(1 child)
u/[deleted]
Thu May 11 22:10:19 2023 UTC
(1 child)

[removed]

1
Thu May 11 23:43:25 2023 UTC
(0 children)

Removed. Rule 7.