AMA! Penile-Preserving, Laproscopic Peritoneal-Pullthrough GCS with Dr. Heidi Wittenberg, Post-Op Week 1

Thu Sep 5 18:01:35 2019 UTC

(10 comments)

(I'm alive! Read my first post if you haven't yet, for background/FAQ)

I had non-binary (penile-preserving peritoneal pullthrough) vaginoplasty with MozaicCare a bit ago! This post covers pre-op & the first week, before getting the packing out.

Note that I'm not going to 1) go day-by-day, nor 2) cover stuff that's the same as all the other vaginoplasty surgeries (e.g. what to bring, what packing is like) unless people ask about it in the comments.

Clarifications

I'd like to first clarify a few answers to questions in the first post:

Estimated Depth

They estimated 8-15cm of depth for me.

Where does the peritoneal tissue attach to the scrotal tissue?

About 1-2cm inside the canal.

Dilation schedule

There was a typo - it's actually the normal dilation schedule (3x daily) not the schedule I said in the first post (1x daily).

1-part or 2-part surgery?

She tries to make it just a 1-part surgery, but due to swelling & such you're probably going to want a labiaplasty.

Pre-Op

Standard & uneventful pre-op appointment, where I clarified that I wanted her to not discard tissue that could (in the future) be used for the labia.

Surgery

There are 5 stomach incisions, one in the belly button and two on each side (symmetry, yay!). Then there's the groin incisions, mostly hidden beneath the packing.

Post-Op

Some hopefully useful notes:

I only had my catheter in for a night since my urethra wasn't re-routed. Peeing normally so soon was a blessing and a curse. It let me be alot more mobile/independent, but with the packing in it's hard to pee and harder to control your bladder.
I had walked a couple laps around the hospital floor a few hours after surgery, and had bowel movement early Day 1. I went home from the hospital in the evening of Day 1.
Holding in poop was the most painful thing, since there's just not enough space down there for stuff. Otherwise pain was minimal, a 0-2 even directly post-op. I didn't take narcotics for pain, and even acetominophen wasn't needed.
The second worst source of pain was all the laproscopic gas left over. They said it would take ~1 month to go away, but it was gone for me maybe ~5-6 days post-op (in the form of lots of farting/burping).
My penis definitely still works. I had a sexy dream, had 3/4 erection, and promptly woke up because ouch .

all 10 comments

u/Androgynoplasty

Thu Sep 5 18:45:01 2019 UTC

(6 children)

Aaaaaaaa congratulations! It sounds like things went very well!

How are you feeling? The first week of recovery was very different from what I expected from other people's accounts of bottom surgery, and I'm wondering how it has been for you.

I only had my catheter in for a night since my urethra wasn't re-routed. Peeing normally so soon was a blessing and a curse. It let me be alot more mobile/independent, but with the packing in it's hard to pee and harder to control your bladder.

For me the catheter was out after two nights. Such a relief, OMG! But yeah totally both good and bad. It'll def get a ton easier when the packing is gone. A portable urinal was my best friend for the first week.

I had walked a couple laps around the hospital floor a few hours after surgery, and had bowel movement early Day 1. I went home from the hospital in the evening of Day 1.

Wow, that's awesome that you were able to leave the hospital so soon. I was there for 3 nights. I could barely move at all the first night without extreme pain due to the difference between our surgeries (skin graft), but I got lots better overnight and got up and did laps on day 1 too.

u/the_weird_stuff

Fri Sep 6 04:08:26 2019 UTC

(5 children)

How are you feeling? The first week of recovery was very different from what I expected from other people's accounts of bottom surgery, and I'm wondering how it has been for you.

Honestly, pretty good by now. Yeah it was alot different than I hear! The packing is the worst part of the first week - you can't change sleeping positions or bend or anything. What was it like for you?

portable urinal

Whaaaat?! I would've loved something like that lol.

Yeah you skin graph sounds...miserable lol. Braver than I.

u/Androgynoplasty

Fri Sep 6 04:36:28 2019 UTC

(4 children)

The padding stitched in place was incredibly annoying to deal with, as every movement of my legs pulled on the taught stitches. It was incredibly abrasive too and the underside of my penis was very roughed up sore and tender from rubbing against it. I thankfully have been a back sleeper most of my life, and I don't move much, so that wasn't so much of an issue as getting into a comfortable position in the first place was.

Going to the bathroom was bad cause the packing and padding prevented me from pointing my penis down into the toilet properly while sitting down for a number 2, which is why I'm so glad I kept the handheld portable urinal from the hospital. It's basically a small jug with a handle and a large opening at the top with a flip lid. Going to the bathroom consisted of me standing and peeing in the urinal, then sitting and going number 2, then pouring the urinal out into the toilet before flushing. Rinsed out the urinal with water after emptying to keep it clean.

For me the skin graft was the worst part. The first week I needed help getting out of bed cause of my abdomen (where the graft came from). The majority of my pain was from the graft donor site, but it was manageable as long as I wasn't stupid and moved slowly. It was much better after a few weeks. During the hospital stay I turned down a couple of the narcotics and stopped taking them the day after getting released, though.

For the record my penis was sore but functioning after surgery too. Had my first post-op orgasm 3.5 days post-op.

u/Chevaleresse

Fri Sep 6 06:01:30 2019 UTC

(3 children)

If you don't mind the question, how is the other bit functioning so far? Finding out that this was an option was a little mindblowing and if/when I get surgery it's what I would go for, but lack of sensation compared to a standard vaginoplasty would be a concern of mine.

u/Androgynoplasty

Fri Sep 6 06:18:46 2019 UTC

(2 children)

Mine was made using a skin graft from my abdomen, so I can't speak from experience to the peritoneal method or any other vaginoplasty method. But I have some sensation inside, it feels pleasant to me, I like it. This is in addition to the standard stuff in place behind the walls of the vagina that feel good, too. The combination is nice.

As time goes on and more nerves come back online as they heal (healing nerves feel like momentary pinpoint scalding hot electric burns just for a few seconds when they come back online, btw) it seems to be getting better, but it takes a lot of time for nerves to heal.

I'm really curious to hear how things go for u/the_weird_stuff , I haven't heard from anyone who had the peritoneal technique yet.

u/[deleted]

Sat Sep 7 02:05:10 2019 UTC

(1 child)

[deleted]

u/Androgynoplasty

Sat Sep 7 04:38:50 2019 UTC

(0 children)

I am currently in therapy for my gender dysphoria and because I can't see myself ever presenting as a female(my dysphoria is almost solely and completely physical) was pursuing full GRS and remaining presenting as male.

There are a handful of folks who have gone this route, and it's totally valid for those it works for.

But this new technique seems like it would be a much better option, assuming one of the Drs accepts non-binary patients.

I'm a non-binary patient. This surgery is aimed at helping non-binary patients, though it is available to binary patients who feel it is appropriate for themselves, too.

Can you answer just a couple questions though?

I'll answer questions again when I make an update post (hopefully soon). This is the_weird_stuff's post though and I'm not going to hijack it any further.

u/illyriarose

Fri Sep 6 04:04:02 2019 UTC

(3 children)

Awesome! I'm really glad your recovery is going so well.

How thorough was your hair removal before surgery? I'm debating getting some last minute electrolysis to touch up a few stragglers before surgery next month.

I have a second consult with her next week to talk about preserving all the scrotal tissue for use in labia and maybe leaving it as is for now to do a full second stage after the vagina heals because I want something different than the default 'Y' sutures under the shaft if possible.

u/the_weird_stuff

Fri Sep 6 04:12:06 2019 UTC

(2 children)

How thorough was your hair removal before surgery? I'm debating getting some last minute electrolysis to touch up a few stragglers before surgery next month.

Meh. It was apparently ~80-90%? I think the more removal the better.

I have a second consult with her next week to talk about preserving all the scrotal tissue for use in labia and maybe leaving it as is for now to do a full second stage after the vagina heals because I want something different than the default 'Y' sutures under the shaft if possible.

Okay so that's super funny - that's what I did!

I still have all my scrotal tissue (I had an orchi last year so its a big wrinkly lump). In 3~6 months I'm coming back for a labiaplasty, where she'll use all that tissue. She says she thinks it'll get the best results and most efficient use of the scrotal tissue.

Hope it all works out for you!

EDIT: quotation nightmare fixed

u/illyriarose

Fri Sep 6 04:34:00 2019 UTC

(1 child)

Hmm, since I haven't had an orchi yet I suspect I might have a bit harder of a recovery.

Did you attempt climbing any stairs on your way home from the hospital? Or do you think that would have required a night of healing first?

u/the_weird_stuff

Fri Sep 6 04:40:45 2019 UTC

(0 children)

Hmm, since I haven't had an orchi yet I suspect I might have a bit harder of a recovery.

Oh yeah it will be. I think most of the suffering from my orchi was just the endocrine system going wack because the testicles were removed. Prepare for weird mind-fog :(.

Did you attempt climbing any stairs on your way home from the hospital? Or do you think that would have required a night of healing first?

Since I went home Day 1 (versus Day 0), I actually did spend a night in the hospital. I didn't sleep more than 2 hours, though, so it didn't really count as a "night of healing".

I had to walk down ~40 steps at home to get to the door. I had someone in front of me walking down, and I rested my weight on their shoulders and walked down just fine. Walking up would've been harder.

The worst part of going home was the ride. My stomach was so full of gas that the force of turning in the car pushing my stomach side-to-side was bad. But my stomach is more sensitive than most I think :~).