Hallo Vanessa,
Ich hoffe du bist fit in Englisch - Ich bin etwas faul das gerade zu übersetzen, zumal ich am Organisieren und Koffer packen bin, denn Freitag geht es los!
Hier zunächst der Link direkt zum Hospital die schon erste gute Informationen zur PPV (SRS-4) geben:
https://www.kamolhospital.com/en/servic ... ssignment/
PPV steht für Penile-Peritoneal Vaginoplasty technique.
Original Text:
This is the most advanced SRS technique for transwomen and Kamol hospital is one of the only hospitals in the world performing it. Peritoneal tissue is tissue that lines the abdomen. It is the most vagina like of all body tissues. It is elastic, it self lubricates in the same way as a cisgender vagina does and without the odour associated with colon vaginoplasty, it doesn"™t demand a lifetime of dilation unlike the other options of penile inversion or using the colon. It is by far the most advanced technique with many advantages over other techniques.
The procedure uses a small amount of penile inversion combined with a peritoneum pull through technique to create the neovaginal canal. Using a peritoneal pull through to create the vaginal canal is not in fact new, it"™s just new for transgender women. This technique has been used in cisgender girls for over 60 years. Known as the Davydov technique it is the only treatment for girls born without a vaginal canal. Known as "MRKH Syndrome" this congenital defect affects a huge one in 4500 girls. Peritoneal tissue is the only tissue used to make a vagina canal to connect the vulva to the womb of girls with MRKH. After 9 month in cis girls this peritoneal tissue is indistinguishable from vaginal tissue under a microscope.
In this technique the outer labia and visible vagina is made using the penis whilst the inner vaginal canal is made using a peritoneal.
The only negative aspect is that there is no long term data on the results for SRS-PPV on trans patients, however the only difference between transgender women and cis girls is that trans women need to have the vulva created and don"™t have a womb. These are however medically inconsequential as making natural looking vulvas is something Dr Kamol has done many thousands of times and has a world leading reputation for. SRS-PPV is less like having a neovagina and more like having a natal vagina. It behaves the same way and no other technique comes close to the function of a biological vagina.
This technique is not only the most advanced method for a realistic, functional vagina but it is also extremely good revision surgery for patients who have previously undergone sex reassignment surgery and who are unhappy with the result or who simply want a more functional realistic, elastic, self lubricating vagina with significant advantages over other methods.
Advantages:
This technique can be used as a primary or secondary neovagina reconstruction.
This technique is beneficial for patients who have previously undergone sex reassignment surgery, penile inversion whose vaginas have developed a loss of depth and are unable to perform sexual intercourse or for those who want an "upgrade" to a more natal functional vagina with less maintenance.
The vagina has a self-natural lubricant.
Less likely to shrink & less chance of vaginal prolapse.
Fewer risks of intestinal dysfunction compare to the sigmoid colon.
Peritoneal tissue is elastic and does not require dilation after a year unlike all other techniques.
Natural lubrication is extremely similar to vaginal lubrication, unlike the colon which has an odour of colon.
Recovery is significantly quicker than both penile inversion and colon vaginoplasty.
No visible scars in the vagina itself (it looks completely natural) and due to laparoscopic (keyhole) technique there are only 2 tiny, virtually undetectable scars from the keyhole surgery- (2 tiny freckle like scars either side of the abdomen)
Significantly less painful than other techniques.
Most similar functionality to a biological vagina.
Peritoneal pull through (davydov technique) has been performed on cisgender girls for over 60 years and is well understood.
Disadvantages and limitations:
The patient may experience dyspepsia / indigestion symptoms 2-3 days after the surgery.
This technique is not suitable for those who are overweight or have fatty abdomens.
In the extremely rare event there is a complicated case, the patient might have the possibility of conversion to open technique or sigmoid colon neovagina reconstruction. This is more or less unheard of.
Dazu habe ich einige Fragen gestellt:
I would give you a brief information of the peritoneal neovaginoplasty as this follows:
1. Full procedure included labia, neoclitoris with hood, vaginal pouch will be created at one stage.
2. The penile skin is used for 3 parts, the clitoral hood, inner labia, and outer part of the vagina canal (pouch).
3. Currently, there are 2 different techniques for peritoneal vaginoplasty;
1# technique, make the peritoneum as a tube and then turn the top to the outside as 270 degrees, to connect the penile skin at the vaginal entrance. This technique is a high possibility of necrosis.
2#, use the peritoneum directly slide downward connected to the penile skin. This technique is more reliable for blood perfusion and no chance of necrosis.
Hence, I use the second one as the first choice.
4. Vaginal dilation is mandatory in the peritoneal SRS, but it's easier and short duration than the penile inversion/colon technique, just the first year after surgery.
5. The vaginal depth of the peritoneum technique is deeper beyond the pelvic floor, the neovaginal pouch is approached the pelvic cavity.
6. There are 2 team surgical teams for the operation; 1# the laparoscopic surgical team created the peritoneal flap, 2# I create the external appearance and neovaginal canal, and control all surgical procedure.
7. The external parts shape and esthetic form depended on penile skin quality included circumcised, normal, or extra size.
8. Scrotal skin is used for labia majora. But in the case of circumcised, it may be used for the outer part of the vagina. So, if you are circumcised, you should have hair removal at the scrotal before surgery.
9. Patient with extra-large penile size, it needed to trim and reduce to fashioned for ideal female genitalia, but sometimes there is a limitation.
Can vaginal canal collapse happen, if after 1 year I NEVER EVER dilate again?
The PPV is the most current technique in SRS, there is no long term (>5 years) study for this technique.
The PPV in genetic female has been started more than 20 years and no recommended for vaginal dilation.
I recommend regular vaginal dilation at least 1 year, after that if you have no active sexual intercourse,
You may regularly check every 1-2 weeks, and do dilation if the vaginal diameter is narrow.
Why couldn`t this happen? - What is so different to colon?
The colon vagina has autonomic muscle contraction, so the dilation is harder.
The colonic mucosa is more sensitive than the peritoneum, sometimes has inflamation, bleeding.
(Cause colon is still tube in original - and the ppv surgery?)
By surgical technique, the peritoneum is cut and then make as a tube, the connect to the perinile skin.
Kurze Zusammenfassung:
- Natürliche Feuchtigkeit ohne möglichen Geruch durch die Darmauskleidung, kein möglicher gelegentlicher brauner Scheidenausfluss
- Dilitieren ist leichter als bei der Colon, ab einem Jahr entfällt das dilitieren (zu vernachlässigen bei Sex = sonst 1-2x "Check" 1-2x die Woche.
- Eine Operation, nicht zwei (bei Erst OP) da der Darm in Ruhe gelassen wird, dadurch schneller Erholung - keine spezielle Ernährung anfangs erforderlich
- Kein Risiko bzgl. Komplikationen am Darm / Krankheiten bzgl. Darm, bleibt intakt bei der ppv (Schlimmstenfalls droht bei der Colon ein künstlicher Darmausgang wie "man mir sagte" (ohne Verifizierung!)
- Kommt dem cis-original am nächsten
- Hohe Erfahrungswerte bei cis-Frauen (aber (!) keine Langzeitstudien über 5 Jahre bei Transfrauen)
- Tiefe um 6 inch (15-15,5cm)
