:: Sex Reassignment Surgery (SRS) Male to Female Surgery

Surgery is not a cure for Transsexuals; the best available treatment is a rehabilitation program that includes surgery. Surgery is usually more successful with patients already enjoying a life in their chosen gender role.

From the standard guidelines for clinical practice, the patient must have met the criteria for SRS, as follows:

  1. Be of legal age in the patient's nation; In Thailand , the father/mother or legal custodian may give consent for patients under the age of 18.
  2. 12 months of continuous hormonal therapy.
  3. 12 months of successful continuous full time real-life experience.
  4. No medical impediments.
  5. Medical letters of recommendation required for SRS: one from mental health professional psychotherapist; the second letter should be from a psychiatrist or a Ph.D. clinical psychologist.
    Surgical transformation or male to female genitalia conversion may make use tissues existing on the patient in the formation of female external anatomy.

:: The goals of sex reassignment surgery

1. To create as normal female genitalia as possible.
2. To achieve adequate neo-vaginal depth.
3. To insure maximum orgasmic capabilities.
4. To minimise and hide disfiguring scar.

The principle of most Sex reassignment surgery procedures involved:
Orchiectomy and high ligation of the spermatic cord.
Penectomy and excision of corpuscavernosa of the penis
Use of corpus spongiosum and urethra to provide a urinary conduit.
Use of penile skin to form labia minora.
Use of the scrotum labia to form labia majora.
On the worldwide basis procedures vary with the tissue available to form the vagina and clitoris:

  1. Penile skin inversion is the most popular procedure for vaginal construction. The skin of the penis is inverted to create a vagina. The glens with its nerve supply are used to create the clitoris, thereby maintaining normal sexual sensation. The scrotal skin is used to form a full-thickness graft to give extra depth to the vagina.
  2. Split-thickness/full-thickness skin graft procedure is performed by some clinics to achieve patient satisfaction. Patients attest to its advantages when the procedure is performed with great attention to detail. However, the donor site scaring and the shrinkage associated with the skin graft procedure are obvious disadvantages.
  3. The sigmoid colon vaginoplasty has been used for decades in Eastern Europe to treat vaginal artesian. Currently, the procedure is used in primary or secondary vaginoplasty. A section of the recto-sigmoid colon is used to form the neo-vagina. The colon serves as a self lubricating neo-vagina. Generally, the low transverse scar is made to resemble a hysterectomy scar.

Expectation after surgery

After you recover from the anaesthesia you may feel pain but it is minimal and usually lasts for the first day and will gradually subside. You will receive IV fluid and some potent antibiotics.

Catheter and Tube drains:
Tube drains and the urinary catheter will be left in place for 4-6 days. After the catheter is removed, you will be able to urinate by yourself while sitting.

Upon waking up you will be able to have drinks and a soft meal in the first few days and you will start regular meals after you are able to have bowel movement.

Vaginal stent:
The vaginal stent will be left in place for 6 days. After it is removed, the neo-vagina will need to be douched at least two times a day in order to keep it clean and free from infection.

The post operative period will require a 6 day stay in the hospital. After the vaginal packing is removed you will be able to walk and leave the hospital. You will also require an additional 7-14 days to recuperate and be ready for travel. You may either choose to stay in a hotel close by our hospital and be taken care of by our staff or you can stay in the hospital as a guest and have a private nurse take care of you until you leave Thailand .

Vaginal dilation:
After the vaginal stent is removed from the neo-vagina, it is then necessary to start to gently dilate the neo-vagina two time a day, for the first month . For about one hour each time with an adequate amount of lubricant jelly. The need to dilate becomes less frequent over time, particularly when you regularly engage in sexual intercourse.

After 8th week of post operation, you should be able to engage in neo-vaginal intercourse. The neo-vagina will need some form of lubrication. In general, patients may have sexual intercourse after they successfully dilate the neo-vagina to the last size of the vaginal dilators.

Return to female hormones:
Patients can return to take female hormones 2 months after surgery but the need for female hormones is less than prior surgery.

Medical certificate:
You will received documents to certified you have successfully undergone sex reassignment surgery.

Insurance and Legal issues
Insurance carriers may specifically exclude transsexual treatment as they do aesthetic surgery. Legal name change and birth certificate amendments are accomplished according to the laws of the particular state or country. http://www.mtfsurgery.com