I had prostate removal 14 years ago, orthascopically. I’m now trying to access vaginoplasty and finding my options limited because of it. I’m being told zero depth may be my only option. I’m trying to find out if A) there are surgeons who would do full depth PI? B) do full depth PPV, C)is there a possibility of a PPV revsion at a later date if i went zero depth? D) Other options?! Another concern brought up was my age (65) in context of safety being under for for long period of time. Thanks in advance!
Vaginoplasty after prostate removal.
Hi! Surgeon here. I’ve asked my colleague who is an expert on peritoneal vaginoplasty to weigh in as well, whether that would be feasible or advisable in this case.
I do penile inversion vaginal plasty and I would certainly offer you that technique, but we both would need to understand that the risk of rectal injury, and the risk of total incontinence afterwards, is sky high. After even a well-done radical prostatectomy, the external sphincter is barely holding on for dear life. When you create the vaginal canal, it would dislocate some of its connections of the sphincter to the rectal area, possibly pushing you over into total incontinence. I see it as “doable” but “high risk”.
As to your age: we frequently operate on patients in your age group. Obviously proper care would have to be taken to understanding any comorbidities you have. As we are full-time, high-volume transgender surgeons, and our operative times tend to be quite efficient and short. It’s routine for us to complete her vaginoplasty in two hours. Even if your operation was particularly difficult and lengthy maybe it would go to four hours… Which is highly manageable period of time to be under anesthesia/surgery.
Also, by sky high can you put a percentage to that.
Unfortunately No. The problem is there isn’t enough experience to say “the risk is 36.56%” or whatever. The problem is those surgical complications are serious and potentially lifelong. Urinary incontinence would really be horrible …and hard to treat. A major rectal injury might require a colostomy….. pretty serious.
Thank you so much for your input. You definitely have my attention and I am reconsidering. It’s just very hard for me. I have dreamed of this for so long. It is almost unbearable To consider the possibility that I will never be able to give myself to a man as a woman does. anyway thank you again! I do really appreciate this.
So I decided to go with the Vulvoplasty. Within four or five days a surgeon that I had spoken with near me had a cancellation and asked if I wanted to have my surgery on 1 September which I did. I’ve been healing up for two weeks now. I have posted two pictures, day one And day 14. Again I really appreciate your input and it aligned with what other surgeons told me. This isn’t exactly what I wanted but I think I can be happy with this. I know I can’t stop looking at myself in the mirror. I feel the surgery has transformed my whole body not just one little piece. Thank you again.
Thank you so much for all your input. It was very informative. I never had anybody say that the risk was sky high just that there was risk. Can I get contact information for your facility?
It would be best to ask a surgeon
I really appreciate you responding. I have asked 4 surgeons so far and of these none are willing to do so. Although two of them told me there are surgeons who can and will perform the surgery. I’m just reaching out to try and find the surgeons who will perform surgery on someone who has had their prostate removed. Thanks 😊
Bellringer can do a PI in 75 minutes if you are worried about being under too long. Think he probably holds the record for the fastest PI Vaginoplasty ever... On me.
***Sorry, deleted the rant.
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