April 18, 2011

Greetings Dr Reed, My name is Velishea.I had SRS in 1981 with a doctor in New York city at the age of 21. Immediately after having had my surgery I had 7 inches in depth. The dilator in those day was a pencil shaped plastic cone and the last inch was tapered. Even though I dilated as instructed, I lost depth. I currently have 4 inches in depth and intercourse is very painful. I went back to my Dr several years and he thought that 4 inches was adequate and I have consulted other Dr here in Houston that tell me the depth that I have is adequate yet intercourse is very painful to the point that I have not had intercourse in over 10 yrs. Aesthetically. the surgery is satisfactory ( it was a two stage) and I am orgasmic. But the depth is a problem one that at my age of 50 yrs old is time for me to resolve it now or accept it. I had a friend that had primary surgery with you and was very happy, and said you were a very honest and talented man, so thought perhaps you might be able to help me. Apart fr

Velishea

Good afternoon Velishea.

Thank you for your kind words.

The natal female pelvis has many suspensory ligaments and intra-peritoneal
features designed to maintain patency and suspension of the vagina.

The male pelvis does not, and nature abhors a vacuum. Dilation ideally
several times a day are advised if you are not sexually active.

Yes, we do surgery for vaginal stenosis. Please see

http://srsmiami.com/photography-m2f.html

example # 13/1-3 The attached is a letter we send
to prospective MTF patients which may be of interest.

Our novel approach has been done so far on 8 patients
with generally good results, but with one notable surgical
site bleeding complication.

We create the space, pack for one week, remove packing
and allowing your skin to re-epithelialize the space
extending your vagina inwards. All the time you must be very
diligent with stent dilations to maintain the space and build
upon that.

Other approaches include:

A. The McIndoe procedure (creating a vagina with a skin graft).

B. The

Vecchietti procedure,

A semi-surgical method that takes advantage of laparoscopy to accelerate dilation.
An olive-shaped device, placed at the vaginal opening, is connected
with sutures to a traction device on the lower abdomen. Under
laparoscopic guidance, the traction device is tightened daily,
gradually pulling the olive-shaped device inward to create a vagina.
This takes approximately one week. The device is then removed
and further manual dilation performed).

C. Colonic augmentation.

Requires an abdominal incision and removes part of your bowel
to become a vagina. May have some unpleasant odors and can
have narrowing at the junction or a red stop light sign in the vulvar area
that will raise questions. Colonic mucosa is more red than pink.
Lubrication varies, but most doctors who do a rectal exam for
other medical reasons put lubricant on their gloves. Some patients
swear by it (like it).

Please see http://www.mayoclinic.org/vaginal-agenesis/treatment.html

Each has its pros and cons.

Our fees are 250 for consultation which can be initiated over the
phone. 9000 for surgery to include closure of anterior commissure
if that needs to be done. Included is use of the facility,
anesthesia and any followup care we provide. In the unlikely event
of hospital transfer I will provide care there gratis, but you may expect
a bill from the hospital and any consultants who may participate
in your care.

You will be required to purchase 500 worth of medical grade
vaginal stents. If you are not sexually active you will need to
dilate after wound healing several times a day to maintain
your vagina. This is also true for MTF patients who never have
stenosis.

Plan on staying at an nearby hotel (the Baltic or Daddy O’s
for a good 10 days post op, so we can start stent dilations
in the office after removal of your packing.

Best wishes and have a productive week,

Harold M. Reed, M.D.
305-865-2000