Sex change surgery/sex reassignment surgery refers to the surgery to change the visual appearance and function of a person’s genitals in order to match their gender identity. There are two kinds of surgery.
Sex change surgery/sex reassignment surgery refers to the surgery to change the visual appearance and function of a person’s genitals in order to match their gender identity. There are two kinds of surgery.
BCOSS doctors have developed an original and ground-breaking sex change technique called the BCOSS technique that gives outstanding results not just by delivering best in class cosmetic appearance, but also a more natural vaginal function.
We use the skin of the glans and prepuce, with all nerves and blood vessels uncut. The penile skin that surrounds glans penis looks similar to skin of the inner labia.. This cannot be used for the whole inner labia. The doctor uses two types of skin to create inner labia look more natural. The outer part is from scrotal skin, and inner part is from prepuces, which is sensitive just like the neo-clitoris.
The G spot of the neovagina is a combination of sensitive labia minora, clitoris and the remnant of urethral flap between dissection. During dilation of the vagina you can feel this sensitive prostatic capsule. This complex of these 5 sensitive organs will create a sensitive vaginal erogenous zone.
Long urethral flap technique: The doctor uses the middle area of the outside, and above the urethral opening to create a urethral mucosa, which is smooth, lubricated, and pinkish in color that appears natural.
The labia minora which are anterior enough to cover the clitoris, uretha, and vaginal cavity (as in cis women).
Labia minora which can be stretched manually (as in cis women).
Pink or red colour of the inner surface of labia minora (as in cis women).
Complete anatomic homology between the reconstructed neovagina and the natal female genitalia.
The frenulum which extends below the clitoris and which is continued to both sides of the labia minora (as in cis women).
Bcoss technique is the development of the second technique that adds to the width of new vagina with a scrotal flap and add the depth with the remaining scrotal skin graft
The operation can be arranged once you have all the required papers ready. Just inform us of your convenient date at least one month in advance prior to arrival, either by click here to contact us via e-mail at consult@bcoss.com, or by faxing us at (66)02-895-6576, or by calling us at(66) 02-895-6565
Tube drains and the urinary catheter will be left in place for 5 days when you wake up you will feel tube drain and the urine catheter that will be left in place for 5 day. You will feel like to urinate because of bladder irritation by the catheter. Do not worry because the urine can gradually pass through the catheter. On the 3rd day you will be easy to move around. We will start to train bladder by clamping urine catheter every 4 hours to keep bladder muscle tone and function normal to reduce the problem of urination. After the catheter is removed, you will be able to urinate by yourself while sitting.
Pain: After you recover from the anesthesia 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. IV morphine for pain alltime in the first day. On the 2nd day the pain will be much subside and oral analgesia can now relieve pain. But if it is still very painful, you can ask for intermittent morphine injection.
Food: Upon waking up you will be able to have drinks and soft meal in the first few days and you will start regular meals after you are able to have bowel movement. Do not have fruit, vegetable or fiber-rich food to avoid passing stool.
Anyway, if you have to pass the stool it can be done but you have to carefully clean the anal area because it is very close to the surgical wound. On the 3rd day, the day that we start bladder training, you can get up and walk around inside the room or sit in bedside sofa.
Vaginal stent: The vaginal packing will be left in place for 5 days. On the 5th day, vaginal packing, tube drain, and catheter will be removed in the same time 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 are recommended to stay at a hotel close by our clinic and taken care of by our nursing team until you leave Thailand.
After the packing removal, there might be some bleeding from vagina and urethral opening. We advise you to stretch your leg, close your knees together and stay still for 30 minutes, the bleeding will stop spontaneously. If it is not stopped, pressure compression by gauze can help to stop bleeding.
After packing removal the nurse will help you to go to the toilet to take the first shower and start to urinate. At the first time to void with all bladder power because it is swelling around the urethral opening. To pass the urine to this area you need more power than normal voiding. If you can void, you can move to the nearby hotel. If you can not pass the urine you have to stay in the hospital and might need catheter retaining for another week.
If you already move to the hotel and have problems urinating, you should come back to the hospital or call our hotline number to give you advice and replace another catheter by our nurses.
If you can pass urine, you can leave the hospital. This is the checklist of stuff that we will provide to you to take to the hotel.
1.Wound Care the wound should be washed gently with Hibiscrub (pink colour) or with betadine solution in the shower followed by douching while seated in the toilet:
After one month of SRS operation you will be required to start applying Premarin cream to your neo-vagina. Apply two times a day to soften your neo-vagina. This would generally take around six months.
Before being discharged from the hospital to your hotel, the nurse will teach you how to take care of your vagina and prescribe some more medications. The stiches will be removed after 7- 10 days. And you will be able to return home.
2. Dilation, During recovery in 3 rd day hotel, the patient must follow patient instructions, including:
Dilation can be painful for the first weeks, but is essential for developing maximum depth and ensuring post operative functioning of the neovagina.
Intercourse:
After the 4th week post operative, 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. Sex partners should wear condom and apply lubricant inside vaginal cavity during neovaginal intercourse in the 1st month to prevent trauma effect from inadequate lubricant. After 1 month intercourse can be done without condom but lubricant still has to be used.
Return to female hormones:
Patients can resume taking oral female hormones in 2 month after surgery but the need for female hormones is less than prior to surgery.
Medical certificate:
You will receive documents certify 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. Patient can return to female hormones as before surgery after two months. You should consult your endocrinologist to re-adjust the dosage. A sudden change in hormone levels, for some individuals, may result in the fluctuation of emotion.
Preparation for surgery:
You will have your genital area shaved, be given an enema (colon cleansing), and start on an IV fluid. No food and drink 8 hours before the operation. The anesthesiologist may meet you at your room or at the operating theatre before starting surgery.
The operation time:
The operation takes 4-5 hours for penile skin inversion technique, and 5-6 hours for penile skin inversion plus scrotal skin graft.
Information | |
---|---|
Anesthesia | General. |
Surgery Length | 4-5 hours |
Side Effects | – |
Recovery Period | Back to work: 2 to 4 weeks. More strenuous activity: 4 to 6 weeks. |
Stay in Hospital | 4-5 days |
Stay in Thailand | 14-16 days |