Confused about vaginoplasty

62
u/katyalovesherbike
Tue Sep 15 07:17:38 2020 UTC
(64 comments)

Hey, first post here as I've had my first srs consultation yesterday for penile inversion and honestly I'm pretty bummed out rn. One of the main things I was hoping for to be possible was getting wet, but it seems this is impossible. However I'm also reading from a number of women here that it is possible for them to get wet, so I thought "alright, they must've had peritoneal pull through" but from the comments it didn't seem that way.

So, in theory is it possible to get wet with penile inversion and where would the wetness come from?

Also, since I'm seriously considering peritoneal pull through right now, can someone highlight the exact differences regarding the outcome? Seems like the main point here is less douching and always being able to get wet, what would be the disadvantages? (except for "no long term data" in trans women?)

all 64 comments


27
u/kitanokikori
Tue Sep 15 09:56:21 2020 UTC
(38 children)

Seems like the main point here is less douching and always being able to get wet, what would be the disadvantages?

The big disadvantage is cost, though if you have good insurance this might not be a problem for you. PPT does indeed get more wet, which is sometimes inconvenient as others mention.

Another disadvantage though rare, is that if your PPT goes wrong, you don't really have a fallback - usually PPT is the fallback, but doing PPT twice in a row is pretty dangerous (I haven't heard of anyone doing this)

Tue Sep 15 13:28:11 2020 UTC
(37 children)

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6
Tue Sep 15 14:24:33 2020 UTC
(35 children)

If you have PI and it fails for some reason, you can still get PPT (ie get GRS again). If you have PPT first and it fails you (obviously) cannot get PI

Tue Sep 15 15:40:17 2020 UTC
(34 children)

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9
Tue Sep 15 17:57:44 2020 UTC
*
(28 children)

I had a peritoneal graft revision for vaginal stenosis. I was down to about 3 1/2 inches of depth and could only get the blue (soulsource) dilator in to about the first dot.

The most common PPT vaginoplasties are actually hybrid PPT/penile inversion techniques. Penile and scrotal skin is still used to construct most of the neovagina and vestibule, and peritoneal tissue is used for the rest. Surgeons like Ting and Avanessian use tunica vaginalis tissue harvested from the scrotum, so obviously you can't do that technique twice. Dr. Bluebond-Langner uses peritoneal tissue harvested from the peritoneum in the abdomen. A flap of tissue, with it's blood supply, is cut from the peritoneum and used to fashion the apex (back end) of the neovagina.

There is a lot less long-term history with PPT vaginoplasty but it has all the risks of penile inversion, plus the added risks of the peritoneal graft. A good summary can be found here .

You can certainly get wet even if you had penile inversion vaginoplasty. The prostate and Cowpers glands are left intact, and if you ever had any pre-ejeculate from your male parts, you will have that same secretion post-surgically. I have a girlfriend who gets amazingly wet from sexual arousal (we both went to McGinn for PI).

After my peritoneal revision (with Bluebond-Langner) I am much more moist and need to wear a panty liner every day. I don't mind, since that constant secretion seems to keep me a lot cleaner as well. I never have any vaginal odor now, which would occasionally happen before.

3
Tue Sep 15 18:08:45 2020 UTC
(0 children)

That's awesome! I always thought I would stay non-op, but stories like yours definitely make me consider SRS.

Tue Sep 15 18:34:14 2020 UTC
(3 children)

[deleted]

1
Thu Sep 17 03:51:06 2020 UTC
(2 children)

What did Dr. Wittenberg say about your outcome? I have PPT with her in May, so this is extremely relevant to me.

2
Thu Sep 17 06:56:09 2020 UTC
(1 child)

She mostly gaslit me, then eventually was basically like "dunno lol". That being said, I haven't heard of anyone else who this happened to, so you should be fine. It's just me that gets to be broken.

1
Thu Sep 17 10:34:26 2020 UTC
(0 children)

I'm so sorry, that really sucks, and that's not at all what I was expecting/hoping for from Dr. W or her staff. I'm not sure if I would be up for a second surgery, either, in that situation.

1
Tue Mar 2 20:26:16 2021 UTC
(22 children)

Is the 3 1/2 inch after the revision? Why is it so small?

2
Tue Mar 2 20:33:39 2021 UTC
(21 children)

No, that was a year after the original vaginoplasty.. That's why I had the peritoneal graft done.

1
Tue Mar 2 20:40:18 2021 UTC
(20 children)

Ooh I hope you're happy

I've been looking into srs and I wish I never had my hopes high. All the methods look terrible to me. And the inside skin won't feel or be the same as a cis girl appearntly. Not to mention the horror stories about necrosis and hair growing inside there. If any of those happened to me I'd insta kill myself. But I'm also desperate, but know that no new methods will be developed anytime soon

1
Tue Mar 2 20:50:19 2021 UTC
(19 children)

It's true that a neovagina is never going to be exactly the same as the "factory installed" version, but they are functional. I just had sex with my boyfriend this afternoon, and it is very pleasurable.

Tissue necrosis can happen but is rarely a clincal catastrophe. I had a small necrotic patch on one of my labia. It turned black, some skin sloughed off, and new pink skin appeared underneath.

If you do genital hair removal prior to surgery, the odds of ending up with hair in your vagina are very unlikely.

There is no denying SRS is major surgery, though. It may involve considerable expense, even with insurance, and can be a rough recovery. Only you can decide if it's worth it to you.

1
Tue Mar 2 20:56:27 2021 UTC
(18 children)

I heard the inside stuff doesn't have the same feeling or as much feeling. Is it true? Tho I heard the exterior is practically the same stuff made from the same tissue and skin.

I guess I'm just paranoid. I sometimes feel like blacking out from the stress when researching about this tbh. And I'm going to move to Canada soon and the closest good sounding surgeon is merci bowers and she is 63 so im scared she'll retire or be too old by then.

Also. I heard both chet and merci say hair removal isn't necessary. Then again I've met many trans women who had theirs at chet end up with hair ;(

To me or seems like I'll do it out of desperation eventually. Waiting for lab grown stuff seems stupid

child comments hidden
7
Tue Sep 15 15:59:23 2020 UTC
(4 children)

Where the vaginal canal seals and/or dies. If that happens and you had PI, you can try again with PPT. If that happens and you already had PPT, you have no second option.

2
Tue Sep 15 18:21:34 2020 UTC
(1 child)

The last resort would be colovaginoplasty.

1
Tue Sep 15 18:31:27 2020 UTC
(0 children)

Correct, though this is further abdominal surgery after you've already had one, which makes it even more risky than before

Tue Sep 15 16:00:23 2020 UTC
(1 child)

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3
Tue Sep 15 18:34:55 2020 UTC
(0 children)

It's pretty rare for something like this to happen to be honest, most people do fine

4
Tue Sep 15 13:45:47 2020 UTC
(0 children)

I dont know the specifics, but coz its not used in inversion, it may be possible to add it?

16
u/cirqueamy
Tue Sep 15 11:48:13 2020 UTC
(7 children)

I had Ting’s PIV+augment with tunica vaginalis procedure 20 months ago. I’m consistently moist, but not wet - no issues with leakage into my underwear. I’ve had one occasion where I became aware that I was “getting wet”, and I can’t say for sure where the moisture came from; but it was quite nice to feel.

I’ve accepted that I will always need to augment my body’s natural moisture with lubrication, which wasn’t all that much of a stretch because it’s been my experience that many cis women also need some artificial lube to help make things wet enough for penetration. Of all the things that make me different from cis women, needing some extra help with lube isn’t one of them.

3
OP
Tue Sep 15 12:37:55 2020 UTC
(6 children)

can you explain this augment procedure a little more? Specifically, can it be done after PIV has been done somewhere else?

9
Tue Sep 15 13:20:58 2020 UTC
(5 children)

The short version is that while performing the PIV, the surgeon harvests tissue from inside the scrotum — the tunica vaginalis, which is basically analogous to peritoneum — and uses it to augment the far end of the vaginal canal. So the vaginal canal is penile and scrotal skin for the first few inches, then tunica vaginalis for the next few.

I’m not a doctor/surgeon, but i would think that it would not work for revising a standard PIV, because this is tissue which would probably be excised and discarded, since it typically resides inside the scrotum, and the standard PIV either repurposes penile and scrotal tissues on the spot, or removes them. I would doubt that a standard PIV would try to preserve the tunica vaginalis inside the body for potential future use.

4
Tue Sep 15 13:47:44 2020 UTC
(4 children)

Ooooooo may surgeon mentioned that he would be using some tunica in his PIV (Dr Kieran Hart, canberra). This is the surgery im getting next year.

5
Tue Sep 15 15:37:52 2020 UTC
(3 children)

Interesting! I haven't heard about Kieran Hart, and didn't actually realise there was another surgeon practicing SRS in Aus other than Ives. I'm not in a position to be able to go for surgery just yet (mostly financial reasons), but was hoping to stay in Australia, and it's good to know there are options! Please keep me updated with how things go!

3
Tue Sep 15 16:11:39 2020 UTC
(0 children)

Look in the wiki here.

2
Tue Sep 15 16:20:23 2020 UTC
(0 children)

Yeah he doesnt really advertise it, its mainly word of mouth. Hes been practicing since 2017, and has done 50 here in aus. A further 37 in london. He is beginning to do perionteal pull through this year, along with the associated price tag. Hes a urologist by trade and very lovely to talk to. 10 months till i get mine. I hope you can get your finances soon.

2
Tue Sep 15 16:29:13 2020 UTC
(0 children)

I should add that i also plan on documenting it all, coz of the lack of information out there about him.

28
u/TronzAnon
Tue Sep 15 07:30:11 2020 UTC
*
(3 children)

The disadvantages that I hear are that your undies will always be soaked with PPT.

A skilled PI surgeon will sample peritoneal tissue from the inner layers of your scrotal skin for the skin graft which is back half of your vaginal canal.

This provides moisture to the vaginal canal, but, at least for me, the "getting wet" part is when I cum and I release a bit of fluid. I'm only 9 months post-op.. so time will only tell how things will change.

I'm guessing the "wetness" I experience is pent up peritoneal moisture in the back of my vagina, and residual lube, and fluid from my prostate, all being squeezed out from the muscle contractions during orgasm.

Looks+smells+tastes like cis vagina cum.

All that being said, I wouldn't worry about getting wet. Lube is sexy. Especially if it looks like cum, which a couple brands have. Make dilation hot, too, and incorporate that into your fun. Also you can lube up hours in advance with the skinniest dilator. Soul Source sells one they call the P1 dilator and it's super super skinny. Perfect for distributing lube.

9
OP
Tue Sep 15 08:27:00 2020 UTC
(2 children)

thank you very much for the detailed answer, I'm going to ask the clinic I've been at whether they're doing that. Guess I'm just stuck rn in a state where every divergence from cis anatomy is a bigger deal for me than it actually is. So all in all, would you recommend PI? Being constantly wet sounds a bit... yucky(?) as well, wouldn't want to sit down in public transport with a skirt 😅

11
Tue Sep 15 14:29:27 2020 UTC
(0 children)

From my experience (non binary), afab vaginas can also be constantly wet. I have a lot of discharge and that's why I always use panty liners or change underwear multiple times a day. It is within the range of a normal, healthy vagina experience.

11
Tue Sep 15 08:34:04 2020 UTC
(0 children)

Yvw. Yea I'm completely happy with my PI (:

Highly recommend haha. Definitely skirt approved.

6
u/WilberTheGiraffe
Thu Sep 24 19:32:11 2020 UTC
(0 children)

I had a Penile inversion and I get extremely wet, I honestly can’t remember how my surgeon says it happens. I believe thru a glad that is left. I went to Dr. Katherine Gast, in Madison Wisconsin. She studied in Europe and does an amazing job. But either way, yes my vagina gets very, very wet. I am so happy it does.

5
u/taikatytto
Tue Sep 15 12:29:26 2020 UTC
(0 children)

One of the main things I was hoping for to be possible was getting wet, but it seems this is impossible. However I'm also reading from a number of women here that it is possible for them to get wet

The difference here is that the surgeon/doctor was probably talking about the vaginal canal which with PI doesn't get wet in itself as it's not mucous membrane. When people here probably talk about getting wet overall, for example the natural lubrication coming from the urethra.

3
u/[deleted]
Tue Sep 15 12:51:05 2020 UTC
(0 children)

I had PI and I'm almost too wet sometimes, like have to wear panty liners just for that. As other mentioned the wetness comes from a combination of peritoneal tissue and the Cowpers gland. PPT will provide wetness in the same way just more thanks to the increased amount of peritoneal tissue but I can imagine that might actually be inconvenient given how wet I get with just having PI.

4
u/Agreeable-Hedgehog19
Tue Sep 15 13:49:11 2020 UTC
(0 children)

From my understanding, getting wet is the result of "precum"/prostatic fluid that some people have.

2
u/willowways
Tue Sep 15 14:48:52 2020 UTC
(9 children)

https://www.mtfsurgery.net/peritoneal-pull-through-vaginoplasty.htm

This arrival mentions doctors that currently perform this. Your best option in my opinion and over all experience would be to contact one of them and ask. Being someone with a damaged urethral canal lining I have wondered what my options are since I was planning on going with Dr. Suporn in Thailand and dr. Bower before that. I have read negative things about the colon one that made me want to avoid that one but I get UTI's almost constantly because of the self harm I had done to the urethral canal lining.

2
Tue Sep 15 16:27:57 2020 UTC
(8 children)

I’m also someone who self-harmed “down there”..would you recommend me bringing that up in my consultation?

3
Tue Sep 15 16:33:45 2020 UTC
(7 children)

Personally yes; very much so. In my case you can't catheterize me anymore cause of urethral stricture. I have scaring along my entire urethra (pee canal/tube thingy). So I have almost constant urinary track infections, a hard time peeing, and pretty sure if they used it for moisture I don't think I would produce enough. So I would say yes if you have issues with your urethra you should bring it up so they know what they are dealing with.

Side note: what to learn from my stupid self harm. "dont stick silicone cal king even non toxic kind in your pee hole to self harm."

2
Tue Sep 15 17:33:27 2020 UTC
(6 children)

I feel like such an idiot now for doing it :/. I was terrified I wouldn’t be able to get surgery because of self-harm

3
Tue Sep 15 17:55:45 2020 UTC
(5 children)

I understand your worries sweety. I get it I do But there is always hope somewhere. Just need to keep looking.

1
Tue Sep 15 19:21:25 2020 UTC
(4 children)

Thank you. <3

2
Tue Sep 15 21:22:52 2020 UTC
(3 children)

Your welcome

2
Wed Sep 16 21:30:45 2020 UTC
(2 children)

I’m curious about whether or not they still gatekeep for gender presentation. I’m nonbinary, but get read as male a lot, and it wouldn’t really bother me except for the fact that...it does. For the zero depth vaginoplasty, do you have to present a certain way?

2
Wed Sep 16 21:37:27 2020 UTC
(1 child)

I’d guess it’s more of an issue getting the psych letter, but you can always present however you need to the surgeon for a few days. I don’t think surgeons much care, but perhaps your one will. Who knows.

Have a look here

https://www.reddit.com/r/TransSurgeriesWiki/wiki/srs/introduction#wiki_real_life_experience_.28rle.29

1
Wed Sep 16 21:40:32 2020 UTC
(0 children)

Thanks again!!