Follow up: Consultation for vaginoplasty with Transgender Center at Washington University Medical Center in St. Louis Missouri

11
u/purplemtnstravesty
Thu Mar 3 13:40:47 2022 UTC
*
(13 comments)

Original Post

Follow up to a post a couple of months ago. I met with Dr Alison Snyder-Warwick (Reconstructive Surgery) and Dr Gino Vricella (Urologist) to discuss full depth Vaginoplasty.

Their website: Washington University Medical Center Transgender Clinic

Pros: local to me, short wait times, extremely nice, eager to build case loads, facility is very nice

Cons: limited case load - they have only performed the surgery since 2019, couldn’t see their body of work or results - only were able to provide one photo but it was in black and white and only 2 months post op, they work as a team but I wasn’t sure who was actually the lead surgeon

Method used: Penile Inversion, they also use a robotic arm to perform the surgery

They want 5 days in the hospital after surgery, will then teach me to dilate. And if there are no issues they’ll send me home after 5 days. I like that I won’t have the added complication of an extended stay away from home, and flying back. After I’m out of the hospital I can find comfort in my own home and have friends local to me for support.

From a medical standpoint, I think they’re able to perform the surgery. They seemed knowledgeable on the questions I asked, but I just didn’t have enough visual data to support my decision to go with them yet. They couldn’t show me their results (only one patient consented to their photo being released) and the photo was in black and white printed off when I requested it. It seemed like it was done well, but it was difficult to tell and I only had the one photo to go off of. There’s just not much of a body of work yet. They did seem extremely eager to build their case load - and the whole center here is eager to provide all the services a transition related healthcare need under one roof. So they were definitely on top of everything and seem to communicate well to other members of their team.

Some questions I asked based on earlier post:

What are the major concerns for possible long-term possible negative outcomes?

They reiterated this is a lifelong commitment to dilating, infertility (they brought up sperm banking)

• ⁠How long after surgery can I start exercising (i.e., running) again?

They said light activities (not exercise) at 3 weeks and that I could do light exercise (not weight lifting) at 6 weeks.

• ⁠How often will I need to douche? Especially long-term? I’ve often heard that douching is not actually needed/healthy for cis women. Why is it needed/recommended post-GCS?

They did not recommend douching and even teetered on recommending against it

• ⁠What are the advantages/disadvantages of the different methods?

Pros - Less complications with penile inversion, less complex surgery, more doctors perform it especially in NA so it’s easier to replicate good results Cons - dilation, not self lubricating

Other techniques: flip flop the advantages and disadvantages for penile inversion

• ⁠What are your rate of complications? How many of your clients go on to get a revision surgery?

They’ve had no major complications requiring additional surgery, and as far as they are aware have had no patients get revisions.

• ⁠What are the concerns as I heal? Depth, sensation, complications, orgasm, etc.

They expected me to have a full recovery with regards to all of these factors

• ⁠What do your waiting times look like?

They said they can get me scheduled 3 months after insurance approval. I need to finish laser hair removal/electrolysis. So I could probably be scheduled a year out if I started genital laser hair removal now.

all 13 comments


4
u/Grateful_Alice
Fri Mar 4 06:00:17 2022 UTC
(4 children)

I had an Orchiectomy with Dr. Gino Vricella. It went really well and I'm overall very happy. I did feel the post-operative care was lacking however. I couldn't schedule a single post-operative appointment until after over 6 weeks post-op.

Avoid Sunyatta with Electrolysis Etc. in Clayton. I don't know how someone can have 16 years experience and be as bad at the job as she is, but she found a way. She may be in the umbrella group as LGBT friendly but I had no notable progress other than scarring with her after months of sessions.

3
OP
Fri Mar 4 09:39:14 2022 UTC
(0 children)

Thanks for sharing on both of those!

I was thinking about going with him for the orchi in the meantime so that’s good to know.

For my laser hair removal I went with Milan laser. They’re expensive, but they do offer unlimited services and they’re nationwide as well. So for the inevitable hairs that end up popping back up they take care of me. It took time but I paid it all off in my 20s so I’ll have the rest of my life to use them (as long as they don’t go out of business). I know it’s not electrolysis but it’s great for getting rid of most of the hair.

3
Wed Mar 9 06:05:21 2022 UTC
(1 child)

Good to hear Dr. Gino Vricella's good. I want to get phalloplasty w him and was concerned at the lack of before and after pics.

3
Wed Mar 9 09:14:27 2022 UTC
(0 children)

Keep in mind an Orchiectomy is generally a simple outpatient surgery. While I am happy with my results, it's not exactly in the same ballpark as a vaginoplasty or a phalloplasty.

3
u/Acafer
Fri Apr 29 17:07:57 2022 UTC
(0 children)

I agree with avoiding Sunyatta. My daughter was only 17 when she started electrolysis but Sunyatta was Very impatient and irritated with her during her sessions. After we left and did laser someplace else my daughter had no trouble tolerating treatment and I realized how bad Sunyatta was.

2
u/ashtonimore_
Mon May 9 05:19:04 2022 UTC
(0 children)

Thanks for posting the follow up, I’m just now seeing this! Tbh recommending against douching for penile inversion is a red flag for me. Almost all major surgeons I’ve seen have talked about how necessary it can be.

As well as only having one photo I can’t say I’d recommend them based off this post. Unless you had no other options of course.

1
u/LexiLee84
Fri Jan 6 04:06:05 2023 UTC
(0 children)

Thank you for posting. It's a 5 minute walk from my work and my endocrinologist is there. I'm going to call to get a consult tomorrow.

1
u/Ostara9
Tue Feb 7 21:25:57 2023 UTC
(5 children)

Thank you for posting, any update on your decision?

3
OP
Tue Feb 7 21:59:22 2023 UTC
(4 children)

I got an orchiectomy with Dr Vricella and a breast augmentation at the same time. I’m waiting until 1 month post op to write an update

1
Tue Feb 7 22:24:31 2023 UTC
(0 children)

Thanks. I'm really curious about that team for vaginoplasty but I'm very wary of them also since your post is like the totality of info there is.

1
Sun Mar 19 08:03:05 2023 UTC
(2 children)

I'm not sure how long ago this has been it 3-19-23 now I'm curious about your update? I live down in The southern part of state around Salem are and am 2hr from st. Louis will have my WPATH guide lines met in 2 weeks and am want to get the ball rolling for me . Even If I have to do like you and just get my orchi and BA. I sure am skeptical about any place in MO because we just don't have many options and especially since I've had my goals set on D. Heidi Wittenberg doing mine and there is just so many things in the way between me and Dr. Wittenberg. Please if you can give us an update on how Orchi and ba went and by now hopefully you have had an awesome recovery on bottom surgery. 😊

2
OP
Sun Mar 19 13:07:47 2023 UTC
(1 child)

Surgery went great! I’m pretty much fully healed by now! Surgery went exactly as planned. I got 295 cc under the muscle natrelle. They’re still doing the drop and fluff but they look much better than the day after surgery. I didn’t want a huge increase in size so I’m happy with my boobs now.

Orchi recovery went really smooth as well. I still want vaginoplasty but this was a nice intermediate step so I can wait on the surgeon I want without the dread of having testosterone creep back into my life. Got my lab work done after and I’m right where I need to be.

Both surgeons and their teams are great. I can’t give higher remarks to them.

1
Sun Mar 19 13:38:18 2023 UTC
(0 children)

This is great and maybe gives me a little hope to at least start some of my process like you. I don't have insurance is my biggest hold up but hopefully it's in my near future also and if not I'm gonna start selling off play toys to at least get a start. I'm so happy for you and thank you so much for getting back to me. Our resources are slim to none here in MO..