Wanted to ask if anyone who had undergone MTF SRS encountered any sort of urinary complications? And if so what was done and the treatment you had done? Thanks.
Urinary Complications after MTF sex reassignment surgery (SRS)
had my catheter removed at about two weeks post op. had too much swelling to see , not even a trickle came out and because I drank alot of water to pee I was so bloated lol. was really painful. still couldn't pee after a few hours so catheter was inserted back in , went home and was instructed to remove it after another 2 weeks , did so and I could pee fine again
edit: uh, why did I get downvoted for sharing my experience ? actual morons
I had issues after my cath was first removed as well. Couldn't pee, was in severe pain and started projectile vomiting. Ended up being re-cathed in the ER where they drained 2 liters of urine. I think that trauma has had long-term effects on my musculature, as in I'm constantly in spasm which makes dilation and sex almost impossible. Seeing a pelvic floor therapist now, 2 years post op.
O.O holy shit that sounds intense. best of luck to you <3
I think it's important to get this info out because now I'm hearing more and more that post-op women are needing pelvic floor therapy, it was a little-known option up until very recently. The complaints about the surgical trauma have always been sort of anecdotal and treated as whining when in fact they are actual, treatable complications.
Good luck to you as well.
Thanks for sharing. I had a similar experience where I was unable to urinate after my catheter was removed and ended up going into the ER room where they had to reinsert the catheter back in me for a week and half. It was extremely traumatizing. I ended up having to get urethral revisions because of my situation. Also, do you ever feel that you have to urinate frequently and that your bladder isn't completely empty?
yep! also had pain while emptying bladder but I assume that was my stomach incision. it does get better after a week or two though
I am about three and a half months post op. I have had difficulties urinating ever since the catheter was first pulled post op. I was unable to empty my bladder properly, which led to a series of bladder infections. I could pee but it felt like the way out was constricted.
Six weeks after my op I ended up in the ER and got taken to the Urology ER due to the constriction that was being made worse by the bladder infection. The doctor was unfamiliar with my operation and was not keen to deal with me and he was right to hesitate. However he did decide to look at me, and whilst trying to find the urethral opening he managed to tear the new vulva in two places. The worst being over the newly built meatus (exit of the urethra). Over the next week it got harder and harder for me to pee, which turned into a complete failure. It turned it that as the damage healed, after a week, the entire urethral opening closed up.
I decided to go to the same hospital where I had been operated to have this looked at after my bad experience at the local hospital. Sadly my surgeon was not available and three urology colleagues tried and failed to insert a urethral catheter.
It was extremely painful. I still have nightmares about it and it felt more like torture than medicine. Eventually after several painful attempted of literally shoving the catheter through flesh,
it was decided to give me a suprapubic catheter. This one goes through the tummy and directly into the bladder. The insertion of this requires a needle to be inserted through the abdomen and through the flesh into the bladder, then it is slowly withdrawn and a local anesthetic is applied. Then a tube is inserted through into the bladder. This was the worst medical experience I think I’ve ever had. That entire day is just a complete PTSD inducing nightmare.
I then had my revision last week. Part of the revision was standard, in that most SRS ops in my country are done in two stages. There was a one centimeter blockage of the urethral opening that was reopened. The stricture was for some reason overlooked and it is still there. One of the tears seems to have been ignored (I was expecting to have it stitched up) and overall I’m extremely disappointed and frustrated that the stricture wasn’t dealt with. My guess is that the obvious blockage overshadowed the more subtle stricture and due to the hospital process (that I didn’t get to speak to my surgeon directly before the operation in person, but to an assistant), the information seems to have been miscommunicated, or overlooked, or ignored.
Now I’m back to where I am before. However I still have the suprapubic catheter in place because I insisted that I wanted a backup in case things went wrong again. It gives me four to five weeks of grace before the tube needs to be removed or replaced.
I could have lived with something that looked bad as long as it worked. However I seem to have both something that doesn’t work and from the perspective of inside the vulva, also doesn’t look great either. It has left me very depressed. I’m happy that the penis is gone, but the emotional and physical cost is really quite high. If I’d known beforehand that I’d be one of the unlucky ones with complications then I’d have chosen to have a much more simple orchi instead.
Two other things of note about surgery issues. My skin and flesh appears to be generally difficult to work with (from the surgeon’s mouth). It was apparently notably difficult to stitch together, tears easily and bleeds profusely. I also seem to be prone to keloid scarring. Had I known that beforehand then it would also have put me off this operation.
I knew what the risks were. I had already researched them before signing the medical disclaimer. In order of severity I had fistula, urinary problems, lack of sensation, poor esthetics in my mind as the problems I could have from worst to livable.
I will have to have another operation to deal with the urethral stricture. But at my age (mid forties) surgery at this level is incredibly physically taxing. I’m absolutely shattered.
The thing about SRS is that you will probably be fine. You might be one of the lucky ones and everything is great. It’s is still a lot of work with dilation even if things go well, but if things go wrong, how good is your surgeon at dealing with that? And do you have the mental strength to be poked and prodded and disappointed of things go wrong? Once you’re on this path you can’t get off it. You have to see it through and live with the consequences. This might seem silly to point out now, but it is very different reading those words, to having to experience it.
Thank you for sharing your surgical experience with me. I feel for you and I'm truly deeply saddened to what you had to go through.
I am one and a half year post op and like you, I encountered urinary complications immediately after removal of the catheter. My urethra felt constricted and tight. I had to strain to pee. I wasn't emptying my bladder at all. I left the hospital and flew back home with a swollen urethra.
Upon my return home my urethra was completely shut. I had complete urinary retention. I had to go into the ER and the urologist on call started poking and puncturing holes to find the opening of my urethra with a wire. He said if he wasn't able to find my urethra that he would of put a tube through my abdomen (suprabubic). Thank GOD! After the third attempt he finally was able to find my urethra. And a catheter was reinserted back in me. I was alone and completely traumatized that night. I left the hospital drenched with urine and blood. I cried all that evening til morning, thinking what have I done to myself.
After a week and a half on the catheter, I was able to find a urologist in my city that specializes in urinary complications after SRS. I went to see him and he removed the catheter. And for the first time ever I was able to urinate. But the story doesn't end there.
All that poking and puncturing in the ER over time caused my urethra to narrow and close up due to scar tissue build up, so I had to go back into surgery to fix and keep open the meatus of my urethra. Long story short. I'm still having urinary issues. At times I feel my urethra tube is constricted and tight and I have to self catheterize myself so to "air it out," in order to begin/start my urine stream.
Looking back at all of this, I regret my surgery. I miss how effortlessly peeing was. Literally before the surgery, I can go in and out of a bathroom in one minute without thinking twice. Today, it takes complete effort and hygiene. We take things for granted in life.
Knowing that I know now. If I could turn back time I would of not of gotten bottom surgery. It really has taken a toll on my body physically and mentally. Like you, I have moments of deep depression and it has effected my quality of life. But its stories like us that need to be shared and not sugar coated because we experienced it. I don't wish what we both went through on anyone. Your not alone on this experience. Thank you again for sharing.
Thank you for sharing your story. We seem to have had very similar experiences. The situation you describe of trying to reopen the urethra was very similar to mike. It left me extremely mentally scarred, not just physically. It felt like a violation and brutal and intimate and I continue to have flashbacks from it. If it’s ok with you I will message you if I make any progress here in my country with this problem.
I'm really really sorry with what you're going through. It makes me sad because we do share those similar experiences. And please keep me posted on your progress. What country are you in?
Germany. I have another meeting with my surgeon in one month. I will see what they have to say about the situation. German is a foreign language for me, so dealing with the doctors in German is sometimes a struggle. I have to research everything and then find and remember the medical translations. It makes it challenging. Like you I scar easily. I wouldn’t be surprised if I have scarring internally that is possibly pushing on the urethra and narrowing it. But the urethra has been shifted so any number of things could have gone wrong. I need to do more research on how this kind of stricture can be fixed.
Please keep me posted and I really hope you get this resolved. Stay Strong Girl!!!
Hi there. I just wanted to see how you are doing and if there has been any progress in trying to fix your urinary situation. Have you considered trying tamsulosin (flomax) to help with flow? I'm currently taking it to help relax my bladder and prostate muscles. I wish I could turn back time and undo my surgery. Have faitha and stay strong girl!
I wish you all the strength and thank you for sharing sister.
No complications unless you count still having pee reaching my butt at almost 3 months post OP. Not sure if it is because there still swelling down there or if the surgeon placed the urethral opening in the wrong place.
Perhaps there still is some swelling and with time that it will subside. Are you taking any kind of anti-inflammatory medications (ibuprofen) for the swelling? Also, do you find that you have to frequently go and urinate and that your bladder is not completely empty?
I literally had my catheter removed yesterday. I was peeing fine for the morning and then during the course of the day I was peeing less and less. Finally at about 6am this morning we figured out that I had a blood clot in my urethra and they put the catheter back into me to take home for a week after already having it in me for nine days. I had a liter of water inside of me that couldn’t get out no matter how much I pushed. It was easily the worst night of my life. Hopefully when I get it removed next week the swelling will have gone down to the point that this won’t happen again.
I'm so sorry to hear about this. Catheters are the worse and I really hope when you get your catheter removed that you're able to urinate ok. Please keep me posted?
Yeah, was a total nightmare. I’ll post again sometime next week.
Not the same person but I was just wondering how things were going now?
I’m peeing okay now—although it was an adventure to start. I had to wear the catheter for fifteen days in total. Recovery has been hard, but it’s getting better everyday.
That is great to hear, but 15 days omg.
I had minor incontinence that was corrected with physical therapy.
Physical therapy o.o? Please explain?
A process of learning to strengthen and control the pelvic floor muscles. On my insurance forms it says neuro-muscular re-education.
It also helps with learning to relax those muscles which makes dilating easier.
Did you have to do Kegel exercises to help with your incontenence?
I started with those on my own and it made a huge difference! I’d do ten every time I peed and within days, I saw a difference.
for how much time did you need to do them?
I’ve just made them a habit. They are easy to do and are good for everybody.
Is there anybody who had swelling of the urethra 10 months post-op? It blocks the canal and it just seems strange. Also the urethra is a bit reddish still. I hope the swelling go’s away but I am not sure. The catheter had to be replaced 4 times and everytime the blatter was extremely full, I hope this has not pushed things permanently out of place. It is hard to find common experiences online and because I appreciate the sharing of other people’s experiences here which helps our community to make informed decisions so I decided give it a try myself.
Sounds like erectile tissue, which is a fairly common complication. Does it get worse during arousal?
Ow wauw, I haven’t even thought of that. I block the idea of the primary sex-organ so much. Sounds plausible. I’m not sure yet, I’ll check. Do you know if it is fixable, if that is the case?
Should be, its a common revision.
https://www.reddit.com/r/TransSurgeriesWiki/wiki/srs/introduction#wiki_erectile_tissue
You MUST use a web browser to view that. Do not use a reddit app, or you may not see all of it.
Thank you so much!
all 34 comments