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Seeking vaginoplasty revision, stream does not go down and urethral bulge

Hi,Dr.Reed,

Need a vaginoplasty revision.  I had my SRS in August 2014,in Thailand .Why,I need the surgery.I always have had a problem voiding,it doesn’t go towards the water,it would either go forward hit the space between seat and bowl,getting my undies wet or hit the bowl, which then splash back at me.My Mon pubs & stomach would be wet with urine.If the stream is weak,it would go down my left side thigh.But always I would have to lift the toilet seat up to wipe the underneath and to wipe top of the bowl.At home I don’t mind.I avoid using public restroom,at times at people’s home.because when I lift the toilet seat up.Sometimes there’s dried splashes from kaka, I gross out.When I spoke Thailand doctor, he mention that my Urethra needs to be shorten and position further back.And,I also mention to him about it hurt when I try to use a bigger dilator. He said the erectile tissue needs to be removed because it swells up and blocking the vagina opening,cause it to lose girth.and because of that I didn’t dilate much which I lost a little depth. But,that’s not really the problem.Its the urethra and erectile tissue (Dr.mention another name for residual erectile tissue, some thing like mucus??????).I just want to be able to use the restroom without having to do all the extra of cleaning up self & toilet.I have talk to my medical insurance, and spoke of the procedure. They said,if Doctor accept United Healthcare,and Doctor needs to say it’s a reconstructive surgery to correct,and using the right medical codes for a pre-authorization consent.Thank you

Karen,

Dear Karen,

Thank you for being such an excellent correspondent. I can
relate to everything you say.

Your vulva now shows some asymmetry, and you need closure
of the anterior commissure (means bringing together the
top side of your labia majora). What I am seeing is a U-shaped
configuration and what we need are mirror image parentheses. Also
revision of a left lower labia majora scar (depression).

Your urethra does not have to be lengthened, it needs to be shortened
(or opened further down). The urethral opening should be below the
pubic symphysis We will also attempt to provide a urethral mucosa
vulva or pink vulva starting at the underside of your neo-clitoris as normal
for a natal female.

Also seen is a prominent urethral spongiosum rest or bulge of spongiosum
urethral tissue or resdual erectiler tissue, (normal for a man) but not a lady. So there’s work to be done.

While we are not contracted providers with any insurance company,
we can give you a compassionate price quote and fill out your insurance
forms for maximal reimbursement to you.

I’ve been “touched” by your detailed explanation and photo and would
like to help you. The last thing you want to hear in an intimate
situation is “what’s that?”

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

 

6/1 - Patient presents with gaping introitus, labial laxity, no clitoral body, poorly defined labia minora. An upper pubic semi-circular skin resection scar represents attempt to tighten labia following original surgery.

Vaginoplasty revision needed for patient done elsewhere

16/2 - Immediate status post-operatively (Reed Centre).

Following vaginoplasty revision by Dr. Reed

Example #2: Male to Female Transsexual Surgery Note clitoral hood, glans, and sulci. Ample introitus is confirmed by passage of our largest stent.

Vaginoplasty patient of Dr. Reed.  Note the closure or approximation of the anterior labia majora, like mirror image parentheses, not a U shaped configuration

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