Sexual Reassignment Surgery
SRS, the Experience.
I started writing this 10 weeks post op. and take the opportunity of giving a report of my surgical experience.
Many girls do report on their surgery but seem to concentrate more on depth of their vagina rather than the whole experience.
The whole experience was amazing and I can honestly say I enjoyed, every minute of it. The whole lot. The surgery, recovery, after care. The removal of the ‘T’ bandage, drains, the dressing, packing, catheter removal, first douche and dilation.
I know it probably sounds strange but it is all part of the whole wonderful experience of achieving full womanhood. I would not have missed a part of it.
There was no pain, only slight discomfort which was easily controlled with co-codomol and tramodol pain killers.
I felt and was treated like a Queen. I felt so serene and elated.
More than seven years later, the feelings have hardly changed since.
So here it is: I was admitted to the Leicester Nuffield on the 9th December 2005 at about 9.00 am. I had stayed overnight at my elder Daughter, Karen’s house as she was taking me and staying for the weekend. My younger Daughter, Emma was joining us on the Morning of my operation and staying over, as well.
We were taken to my room where the nurse came to fill out the paperwork and take blood pressure, temperature, etc. We were joined by a technician to take blood for grouping and make sure that all was well for my surgery.
The nurse left and then one of the kitchen staff came to see what we wanted for lunch and dinner. My Daughter opted for a sandwich for lunch but would eat at the hotel in the evening. I was told that I had no choice and it would be consommé soup and runny jelly for lunch and dinner.
For drinks I could have tea or coffee, without milk and sugar and watery orange squash. I would also be having two doses of Pico lax, a very strong laxative.
That would be the last food or drink until the following Wednesday morning.
The remainder of the day was blood pressure tests etc. playing cards and watching DVD’s. Oh yes, sitting on the toilet. That Pico lax is strong stuff.
My Daughter left at about 8.00pm to go to her Hotel. She arranged to come back at about 8.30am next morning.
I went to bed at about 10.00pm but spent most of the night watching Telly or sitting on the loo. I suppose it was partly nerves but mostly excitement.
Saturday Morning, this was it, the day had eventually arrived. It felt rather strange, almost dream like.
About 7.00am, Saturday morning the nurse came in and said to have a shower at about 7.30am as I will be going up at 8.30am for my op.
I quickly rang Karen and told her the op. would be an hour earlier. No problem as Emma had already arrived. They got there at about 8.00am. By then, I had showered, put on the operating gown and surgical stockings. I was ready. Oh I was so ready.
Tim Terry, my surgeon arrived about ten minutes later and said my girls could stay while we discussed the surgery and could also ask questions.
He explained the whole procedure and the risks involved. He explained that he would not normally give a vagina to someone of my age as the older you get the blood supply usually reduces, increasing the risk of failure. In my case he did not think that would be a problem as I had a good supply of blood to the genital area and my previous surgical experiences have shown a very good healing ability.
He explained that he would carry out a penile scrotal inversion vaginoplasty. He would at the same time carry out a clitoroplasty which is sensate in about 80% of the cases.
He will also construct the labia in a 'v' or 'w' dependent on the amount of tissue available.
He again explained the possible complications of this operation. Deep venous thrombosis, pulmonary embolism which was why I had to come off the hormones six weeks prior to my surgery. He mentioned Post op. bleeding which is why I stopped the aspirin two weeks before.
In the unlikely event of a rectal injury it can be repaired primarily without the development of a fistula.
He said that if I were to develop a post op. fistula that I might need a temporary defunctioning colostomy bag and further vaginal surgery.
He then discussed the issues involving the urethra including spraying, direction of stream, meatal stenosis and urethral prominence. He went through the potential problems of the vagina including depth, width, formation and prolapse. In some cases the clitoris may be hyper or under sensitive requiring the clitoris to be removed. We also talked about post op. infection and skin flap necrosis.
Even though the risks are real they are less than one percent and low.
About 80% of all patients at six weeks post surgery are functioning and are cosmetically happy with the results of their first surgery and are discharged. Some secondary surgery is required and in most cases is minor and can be done as a day patient.
All of this was explained at my initial consultation and confirmed in his letter.
He asked if I had any questions and I said yes, that I would also like a clitoral hood as well. He normally does that as a separate operation, about 6 months later. This is due to the risk of insufficient blood supply to the clitoris. I said that if the risk were low I would still like it but leave it up to him entirely. The Anaesthetist also joined us and he explained his procedure. I was then asked to sign the consent forms. They then left to prepare for my op.
I gave both of my Daughters a present and letter and told them not to open them until I went up for my operation. They contained a Gold twist bangle each and fifty pounds to go for some retail therapy to help take their minds off my operation. I cannot imagine what they must have gone through particularly knowing what was involved, the risks and the changes I would be undergoing.
I think they are both truly wonderful and love them to bits. I am so grateful for their support.
A few minutes later the theatre assistant and gender nurse arrived to wheel my bed to the theatre.
At the lift, my daughters gave me a big hug and kiss. We did not want to let each other go. We were all crying. It was a very emotional time. I know that they were really scared for me and cannot imagine what thoughts and emotions must be going through their minds.
It had finally arrived. I felt emotional and excited, yet still worried that I would wake up and find that they had not been able to do it.
The last I remember is the needle being put into the back of my hand and then Tim Terry saying to me in the recovery room that everything went well and he was able to do everything. Next I awoke back in my room and my two girls were there with me.
They told me that TT had seen them and said everything went well and that he will call in later. Apparently, I had been given, six and a half litres of saline during the four hour and forty three minute op. I then sensed all the dressing around my waist and between my legs. It had actually been done. I felt so wonderful and went back to sleep. I awoke a while later and my girls said they are going back to the hotel for an hour or two.
I slept until about 6.00pm. I was now more or less awake and noticed a couple of cards and some presents on my cabinet.
I opened the cards, both from my daughters, both amusing. Karen and Emma returned at about 6.30pm and Tim came in shortly afterwards. I asked him if I heard him right, in the recovery room and had he been able to do everything. He replied that he had and he managed a depth of over 5” and also a clitoral hood.
I said that if I were not flat on my back, I would give him a big hug. He said we could have a hug before I went home.
I felt overwhelmed, elated and so wonderful. Words will never be able to describe it. This had been the happiest day of my life.
My Daughters left at about 8.30pm to go back to their hotel for something to eat. My sustenance will be saline drips and water, for the next 5 days. The remainder of the day was spent with temperature, blood pressure, checking vaginal drains and emptying the catheter bag. Next five days will be flat on my back.
After they had left, I cried tears of happiness. I cried myself to sleep.
Sunday, I awoke very early. Throughout the night the nursing staff had been in checking my vital systems, changing drips, giving me sips of water and generally caring for me.
I felt that I needed to pee. I knew I could not get out of bed so I rang the bell. The nurse came in and reminded me that I was catheterised. It was the catheter causing some irritation that would soon go. That would stay in until Friday.
As the morning dawned realisation came to me that I had, had my surgery and it was truly all over. I, again, cried with happiness. I was overwhelmed, never had I experienced such feelings. The rest of my life has really started.
It was bed bath time. Have you ever been washed, flat on your back, wrapped in a large, sumo wrestler dressing, with a catheter and two drains coming out of it and a drip in your arm, crossing to the wrong side of the bed? It is certainly different.
Firstly they had to remove the soiled sheets and operating gown. This involved feeding the drip through the sleeve. Once achieved the frame was moved to the other side of the bed.
Next came the injection of heparin, anti- clotting drug, into the stomach.
Compression socks came off and then the wash. I was left to see to my own breasts, face and arms.
Then the clean gown, drip through the sleeve in reverse. Clean bedding, compression socks back on.
The catheter bag was then emptied.
Blood pressure and temperature and then I was then left exhausted in my bed and drifted off to sleep.
This would be the regime for the next few days.
My Daughters arrived at about 10.30 am. They always have me laughing within minutes, this morning was no different.
They asked how I was, much pain and what sort of night I had, had? It occurred to me then that I had not had any pain, only slight discomfort, which mild pain killers were able to control. I was surprised how good I felt, seeing that it was only less than 24 hours since I had been undergoing major and complex reconstruction surgery. This is a tribute to the skill of Tim Terry my Surgeon and his staff.
I asked if they were able to get dinner last night. They said there was a function back at the hotel, it was quite busy so they had room service. But, they said it was lovely. I told them to have whatever they wanted, it was on my bill.
Sue the Gender nurse called in and said that Tim would be in to see me soon. She saw the card that Karen and Emma had bought for me, with the dog. She thought it were hilarious and showed it to the other nurses.
Tim Terry called in mid- morning, to see how I was. He told me that the surgery was very pleasing and he was able to give me depth of over five inches. He said would be back in the morning to removed the T- bandage and drains.
The rest of the morning consisted of blood pressure, temperature, etc.
The morning went past in a delirious haze, delirious with joy and happiness.
After lunch, saline drip and water, delicious, my Daughters had, had a full cooked breakfast and did not want anything, my friends, Sophie, her wife, Debbie and friend Linda arrived.
It was lovely to see them and they all chatted away with my Daughters. I was a little bit anxious as they had never seen any of my friends before. I needn’t have worried and they got on famously, as though they had known each other for years.
They left just before five, as Sophie was working.
My Daughters left about an hour later. They both had to get back to their families, Karen at Milton Keynes and Emma at Luton.
They have arranged to come back on Saturday, to take me home Sunday. They enjoyed their weekend here, so much, that they booked back into the Hotel again. I told them to make sure it was billed to me.
Suddenly it was quiet and I could lay back and think about all that had happened, during the last day or so. I still have to keep on pinching myself, that it had really happened, ‘I was now all woman’. It is so wonderful. I do not think I will ever come down from this high.
The rest of the evening carried on in the same manner, blood pressure, temperature, sleeping thinking, all the time, apparently with a silly smile on my face.
Next morning I was awake quite early, still no pain, only slight discomfort. The nurse came in and did usual blood pressure checks, etc and looked at the intraveneous needle. She said it looked a bit red and would have it looked at. She said that Tim would be in shortly to remove the 'T' bandage and drains. The sister came in and put a new needle in the other hand.
They checked the dressing and Sue said good gracious what have you been doing with the dressing. There was cotton wool all over the bed where it had broken up with my fidgeting.
Tim arrived some time later. He had a tray with him. He took off his jacket washed his hands with alchohol wash and proceeded to remove the 'T' bandage and the remains of the wool padding. I thought that this would leave my new genitalia exposed, so that I could have a quick look. No such luck. There was another dressing over the whole site that was held in place with stitches. I would still have to wait.
Sue came in at this point.
Tim was ready to remove the drains. I was dreading this as I had heard that it is very painful. Tim cut through the stitches that held the drains in place, which I hardly felt. Then he drew the drains out. All I felt was a slight fluttering as they came out. It was done.
He said he would look in tomorrow and come in Wednesday to remove the rest of the dressing and packing. I will then be able to see it at long last.
The nurses came in, shortly after and tidied my bed and removed all the bits of cotton wool.
Usual blood pressure and temperature, new saline bag and anti-biotic, heparin injection and fresh iced water. No food until Wednesday.
Alone again for a while. By now I was exhausted again and slept.
About 11.00am my friend Paula arrived with a big bunch of flowers. Sue came in shortly, she knows Paula as she was her gender nurse 6 weeks earlier. Paula is also a Tim Terry Graduate.
Lunch time arrived and Paula said that she would go outside and have her lunch. I told her I would not hear of it so she got out a sandwich and bottle of fizzy drink.
I was not feeling hungry, even though I had not eaten for nearly four days and what I had eaten beforehand had been cleared out.
In the afternoon, another friend Jenny called in to see me. She stayed for about an hour. Jenny and Paula know each other, living about 9 miles apart in West Yorkshire.
Paula stayed until about 9.00pm. During that time the usual blood pressure temperature, emptying the catheter bag. The saline bag was removed as I was fully hydrated and now had to exist on water alone.
Tuesday was a fairly quiet day, normal blood pressure temperature, clean bedding.
The drip was removed as I was completely hydrated but was told to drink plenty.
My friend Carol called in that afternoon, she had her surgery with Tim, back in February, at Leicester General. It was she that first spoke positively about Tim that decided me to at least give him a chance. She stayed a couple of hours.
Tim Terry also looked in to see how I was and said that he will see me in the morning to remove the dressing and packing. I will be able to see it at last.
Today is the big day, where Tim comes and removes the packing and I at long last get to see my new vagina and female genitalia.
He was due in the morning but got delayed and it was after lunch that he arrived. By now, I was getting quite impatient to see the new me.
His gender nurse followed him in.
He took his jacket off and cleaned his hands.
He removed the stitches that held the dressing in place and then said he was going to pull out the packing. There seemed to be yards of it and it was a lovely fluttering feeling, deep inside.
He asked if I would like to see it, would I? there was nothing that I wanted more.
He took my mirror off the side and held it in position so that I could see it. It was wonderful, it was swollen, bruised and quite messy but so wonderful, after all these years………………
The nurse cleaned me up got me a clean pair of knickers and put a sanitary towel inside ( to be called ST's) and before Tim left he told me that I could now start eating but stay in bed until tomorrow.
They left me to my thoughts.
And did I eat. Yesterday, a late lunch of a soup, sandwich and coffee and for tea, I had soup as a starter, steak and ale pie for main course and ice cream for my sweet. Orange juice with the meal and coffee.
Breakfast of cereal, smoked salmon and scrambled egg with toast and coffee.
I then got up and sat in the armchair, by my bed. After a while I started to feel sick. I called the nurse and soon after I threw up. She asked what I had eaten and said that I should have been on a light diet for a day or so.
She put me back to bed, where I stayed for the rest of the day.
At least I had on my own nightie and knickers.
Less blood pressure testing and the daily heparin but at least I could go to the bathroom to wash. Have to carry my catheter bag around. Still it comes out tomorrow.
Paula came in later that day. She was seeing Tim Terry for her 6 week check up that evening so spent the day with me. This visit, I was able to eat with her, light meals only.
Tim carried out his daily visit. Tomorrow the catheter comes out.
The nurse came into my room next morning, after breakfast. Normal routine, blood pressure, temperature, heparin injection, checked the surgical area. The gender nurse then came in and they removed the catheter. I was told to drink plenty and when I need to pee, use one of the containers in the loo to collect it. If I cannot go they will have to refit the catheter.
As it happened, I started feeling uncomfortable a couple of hours later and decided to try. I went out to the loo and just got my knickers down and my ST off, sat down just in time and had my first female pee. It was so special that I cried.I soon learnt that when I have to go, I cannot hold it as long as I used to.
Much has changed and much is different but so better.
A quiet day today; no visitors, the first since I have been in hospital.
Tomorrow, Tim starts me dilating and Karen and Emma are back for the weekend to take me home on Sunday, all being well. I could not wait to see them. What wonderful Doughters.
Tim is due in this morning as well as my Daughters.
My Daughters arrived at Mid-morning. We had a chat and a coffee and then they went to check in at the Hotel and go into Leicester shopping centre.
The nurse came in and took me into the shower in readiness for my first dilation. It was quite exciting but I was a bit nervous at the same time.
Tim arrived a while later and started to dilate me. He showed me the different dilators and said we can throw the smallest, the 20mm, I would initially use the 25mm and 32.5mm before going up to the 37.5mm.
He cleaned and lubricated the dilators and entrance to the vagina and carefully inserted the smaller of the two I would be using. He explained how to do it as he went. He held the mirror so that I could see how it was in. He left it in 10 minutes before using the larger. This one hurt a bit but not surprising when you consider how my vagina had been created. My vagina, what a wonderful thought.
This one he left in for a further ten minutes. He told me that for the next three months I would need to dilate 3 times a day. The Sister would do the next one and would supervise this evenings while I did it myself. I must be scrupulously clean to avoid any infections.
He said I had a good depth and width and should finish about 6" in depth and accommodate the 3.75cm dilator. (In fact, I have just under a 6" depth and can take a 5cm dilator but now rarely dilate)
He will come back and see me tomorrow and all being well, he will send me home.
The nurse then showed me how to douche. I showered and laid on my bed. I was exhausted and slept a couple of hours.
I will have to dilate for the rest of my life, to maintain my vagina, though the frequency will reduce to eventually, about once a week or so.
My Daughters returned, after lunch and we spent a pleasant few hours together, until they left in the evening to go back to the hotel for Dinner.
They would return next morning at about 10.00am to take me home, if discharged.
The Sister came in just after and prepared me for my second dilation, which she did for me. She said she would come back at about 10.30pm to help me do the next one.
Tomorrow, I would be left to do it myself but they will be nearby in case I need any help.
My tenth day in Hospital, all being well I will be going home today. I have been to toilet once and peeing regularly, spraying a bit but otherwise, great.
The nurse came in after breakfast and did the usual blood pressure, temperature and heparin injection and helped me prepare for the morning dilation. She put a 'do not disturb' notice on the door and left me to it.
I must admit, I was nervous but had to get on with it, as I would be on my own, when I get home. As it turned out, it went quite well though the larger dilator did hurt a bit. After 20 minutes, I cleared up and then showered, put back on my nightie clean knickers and ST.
I laid on my bed and slept for about an hour.
About 10.30 my Daughters arrived.
After lunch, Tim arrived. He examined me and said everything looked good. He asked me about peeing etc. and I told him everything is working well. He asked about dilating and said that I could go home. I thanked him for what he had done for me and what he had given me and what it meant. We then had a big hug. I felt quite emotional.
He said the nurse will bring me some medication to take home, ST, pressure stockings, douche and cleaning fluids. He said to get my GP to prescribe extra if required, a letter for my GP and that I could restart my hormones at the end of the month.
He would write with a follow up appointment for about 6 weeks.
After he had left, my Daughters packed my suitcase, while I got dressed.
I gave the nurses, boxes of chocolates and left one for Tim.
The nursing staff, I could not fault they had been so attentive and could not do enough. Tim had visited every day, sometimes several times and is very hands on.
I said my goodbyes and my Daughters took me home.
In conclusion.
Recovery was very quick. The stitches started dissolving after about two weeks and most swelling had gone in about 4 weeks. By then I felt I could do almost anything, but I did not risk it.
Tiredness was the most noticeable thing, You would feel full of energy, then all of a sudden you would feel very tired and I would often sleep.
This was all part of the healing process. This lasted over 3 months.
I saw Tim after about 7 weeks post op. and he said healing had been excellent and that I could resume a normal life. However he would do a small clitoral hood reconstruction as the clitoris was not properly hooded. He would leave this six months. This was done the following June.
Now, more then fifteen years post-op. I have actually completed this page.
That feeling of joy, happiness, elation that I felt immediately after my op. has mellowed but still with me and I still view my body with wonderment.
I have been dating a lovely man for more than fourteen years, whom I love dearly. He is a big, kind, and gentleman and I know he cares for me as well.
It is truly wonderful being a woman. I would not change a thing.
