According to The World Professional Association for Transgender Health (WPATH, formerly known as the Harry Benjamin International Gender Dysphoria Association, Inc. (HBIGDA) or http://www.wpath.org), genital surgery is not a cure for Transsexualism. The best available treatment is a therapy program that includes surgery. Surgery is more successful with patients already enjoying a life in their chosen gender role.
The requirement for Male to Female SRS/GRS:
1. Should be of legal age in the patient’s nation. In Thailand, the father, the mother or the legal custodian may give consent for patients under the age of 20.
2. At least 12 months of continuous hormonal therapy.
3. At least 12 months of successful continuous full time real-life experience.
4. Physically fit for surgery.
5. Medical letters of recommendation for SRS/ GRS.
during the clinical consultation, you will be interviewed and your health evaluated to determine if you are a good candidate to undergo SRS/GRS. The quantity and quality of skin will be examined to evaluate the vaginal depth.
The goals of male-to-female sex reassignment surgery include:
1. To create of a sensate and aesthetically acceptable vulva which include clitoris, labia minora, majora and vaginal introitus.
2. Shortening of the urethra, with creation of a urethral opening that allows a downward urinary stream.
3. To eliminate of erectile tissue completely (to avoid narrowing of introitus and protrusion of the urethral during sexual arousal.
4. To achieve adequate vaginal depth.
5. To preserve orgasmic capabilities.
6. To minimize and hide scarring.
Dr. Kamol’s standards for performing SRS/GRS from male to female are as follows:
1. Highest safety during the operation process.
2. The creation of a functional vagina with normal sensations and feelings.
3. External appearance as close as possible to a genetic female, with less noticeable scarring.
4. Less postoperative pain after the surgery.
5. Patients usually recover quickly and return to their normal routine.
Our nursing staff will provide excellent post-op care. After the surgery, they will perform the necessary care and do the dilation until your departure. This will be done twice a day. We also extend our sincere friendship to you and hope you will keep in touch with us and let us know of the progress in your new life. We feel this will help our patients both physically and emotionally towards a speedy recovery.
Dr. Kamol’s GRS/SRS avantageuse unique technique:
Dr.Kamol’s surgical technique
1. Most surgeries are under general anesthesia. However, a patient can choose to have epidural anesthesia.
2. The operation is performed in one stage procedure, consisting of vaginoplasty, outer labioplasty, inner labioplasty, urethroplasty, and sensate neoclitoroplasty.
3. Orchiectomy: Dr. Kamol performs orchiectomy in every operation of SRS, in order to prevent production of male hormones.
4. Depth of neo-vagina will be 5-6 inches on average for a western male. However, in some cases, immediate results after surgery could be up to 7-8 inches. Long term results are different depending on many factors such as dilation and wound care.
5. Erectile tissue removal: Dr.Kamol makes special attention to remove the erectile tissue around urethral opening as much as possible, to prevent the excess skin and erectile tissue below the urethra.
6. For the vaginal wall, Dr.Kamol offers two choices:
a. Scrotal skin graft, most of cases need scrotal skin for the optimum depth. However, the patients may need extra skin from the groins or lower abdomen in case of deficient scrotal skin.
b. Sigmoid colon Vaginoplasty, it’s the procedure for patient who needs self-lubricated and more elasticity vagina. It’s a procedure of choice for secondary vagina reconstruction in case of post SRS-vaginal stricture.
7. Prevention of the deep vein thrombosis (D.V.T.), we use the Sequential intermittent compression sleeves (S.I.C.S) machine.
Expected course and recovery
Pre-operative
1. Following receipt of letters of recommendation and initial interview with the surgeon to determine appropriateness of SRS, a history and physical examination will be performed. The surgeon will explain the expected course and recovery period, risk and complication.
2. Genital electrolysis should be done prior to SRS. To prevent hair in and around their new vagina caused aesthetic and functional concerns. The patients should remove by electrolysis one to six weeks before SRS at the area showing in the picture.
3. The patients must be stop smoking 2-4 weeks prior the surgery because the effect of smoking to skin quality, wound healing and vascularity will be interfere the optimize results.
4. Patients have to stop feminizing endocrine therapy 2-4 weeks prior to surgery, medications affecting the coagulation cascade must be stopped 7-10 days prior to surgery. Prior consultation with an appropriate physician is required in the case of complicating medical factors.
Peri-operative
Patients are admitted and will undergo bowel preparation. To clean the bowel, the patient takes nothing by mouth prior to the surgery 6-8 hours. Blood will be drawn 20 cc. and EKG (electrocardiogram) will be obtained. A chest x-ray is taken. A pre-operative shaving will be undergone prior to their surgery.
Hospital staying will arrange 6-8 days and the patient will remain on bed rest restriction for much of this time. Analgesic controlled, anti-coagulants and antibiotic will typically remain on parenteral until the patient is mobile. Vaginal packing will be placed into the neo-vagina at the time of surgery and will be left in place for 5 days to ensure the flap will be well apposed to the inner vaginal walls in maximum dimensions. After this, foley catheter will be removed.
Post-operative care
Our nursing stuff will provide excellent post-operative care. After the surgery, they will perform the necessary care and do the dilation at least 2 weeks or until your departure this will be done twice a day. We recommend the clients to stay at a hotel close by our clinic as you are required to come to clinic twice a day for dressing and dilation.
Vaginal dilation
It is necessary to start to gently dilate your vagina two times a day, for the first couple of months, for about one hour each time, with an adequate amount of lubricant gel. The need to dilate becomes less frequent over time, particularly if you regularly engage in sexual intercourse. In case of no sexual intercourse after six months, the dilation for the vagina is needed twice a week.
The importance of dilation and post-surgical care
Dilation is the most important task you must do to ensure the success of your surgery. If you do not dilate responsibly, this can result in the shortening of depth and vaginal stenosis, including partial to total collapse.
Failure to properly dilate in the early stages can result in patients experiencing excessive vaginal pain at late times. In order to achieve more depth and to avoid vaginal obstruction it is very important that you follow the dilation.
You will be instructed on proper and gentle dilation technique after the vaginal packing is removed. Dilation is essential for developing maximum depth and ensuring post-op functionality of your vagina.
Sexual Intercourse
After the 3rd month post-op, you should be able to engage in normal vaginal. We recommend using gel as a form of lubrication. If you are healing well you can engage in intercourse after 2 months. In general, patients may engage in sexual intercourse after they get to dilator number 6.
Return to female hormones
Patients can resume taking female hormones in 10 - 14 days after the surgery but the need for hormones is less than prior to surgery, about 1/2 to 1/4 of preoperative doses. Before returning to hormones it is recommended that you check with our surgeon first. Our clinic director can assist you on what types and doses should be taken.
Medical Certificate
After the surgery, you will receive a Medical Certificate, given by the surgeon, stating that you have successfully undergone Sex Reassignment Surgery. It is of the client’s responsibility to provide us with the necessary information to be included in the certificate to meet the requirements of your country for legal purposes.
The process for legal name change and birth certificate amendments as well as other registered documents, is the responsibility of the client and it should be done in the client’s country according to its laws and regulations.
Possible risks and complications
1. Post-operative bleeding or Hematoma
2. Infection
3. Wound healing problem
4. Recto-vaginal fistula
5. Partial or complete flap necrosis
6. Intravaginal hair growth
7. Hypertrophic scaring
The requirement for Male to Female SRS/GRS:
1. Should be of legal age in the patient’s nation. In Thailand, the father, the mother or the legal custodian may give consent for patients under the age of 20.
2. At least 12 months of continuous hormonal therapy.
3. At least 12 months of successful continuous full time real-life experience.
4. Physically fit for surgery.
5. Medical letters of recommendation for SRS/ GRS.
during the clinical consultation, you will be interviewed and your health evaluated to determine if you are a good candidate to undergo SRS/GRS. The quantity and quality of skin will be examined to evaluate the vaginal depth.
The goals of male-to-female sex reassignment surgery include:
1. To create of a sensate and aesthetically acceptable vulva which include clitoris, labia minora, majora and vaginal introitus.
2. Shortening of the urethra, with creation of a urethral opening that allows a downward urinary stream.
3. To eliminate of erectile tissue completely (to avoid narrowing of introitus and protrusion of the urethral during sexual arousal.
4. To achieve adequate vaginal depth.
5. To preserve orgasmic capabilities.
6. To minimize and hide scarring.
Dr. Kamol’s standards for performing SRS/GRS from male to female are as follows:
1. Highest safety during the operation process.
2. The creation of a functional vagina with normal sensations and feelings.
3. External appearance as close as possible to a genetic female, with less noticeable scarring.
4. Less postoperative pain after the surgery.
5. Patients usually recover quickly and return to their normal routine.
Our nursing staff will provide excellent post-op care. After the surgery, they will perform the necessary care and do the dilation until your departure. This will be done twice a day. We also extend our sincere friendship to you and hope you will keep in touch with us and let us know of the progress in your new life. We feel this will help our patients both physically and emotionally towards a speedy recovery.
Dr. Kamol’s GRS/SRS avantageuse unique technique:
- Single stage procedure.
- Very minimal scarring.
- A much shorter exterior scar that is well hidden.
- Ability of patient to wear G-string when healed and look like a genetic female.
- More sensory tissue is kept and used to create female genitals.
- To create a vagina that is aesthetically close to the natural one.
- A labia majora and labia minora aesthetically close to the natural one.
- Excellent vaginal depth of approximately 5 - 7 inches.
- More fullness of mons pubic.
Dr.Kamol’s surgical technique
1. Most surgeries are under general anesthesia. However, a patient can choose to have epidural anesthesia.
2. The operation is performed in one stage procedure, consisting of vaginoplasty, outer labioplasty, inner labioplasty, urethroplasty, and sensate neoclitoroplasty.
3. Orchiectomy: Dr. Kamol performs orchiectomy in every operation of SRS, in order to prevent production of male hormones.
4. Depth of neo-vagina will be 5-6 inches on average for a western male. However, in some cases, immediate results after surgery could be up to 7-8 inches. Long term results are different depending on many factors such as dilation and wound care.
5. Erectile tissue removal: Dr.Kamol makes special attention to remove the erectile tissue around urethral opening as much as possible, to prevent the excess skin and erectile tissue below the urethra.
6. For the vaginal wall, Dr.Kamol offers two choices:
a. Scrotal skin graft, most of cases need scrotal skin for the optimum depth. However, the patients may need extra skin from the groins or lower abdomen in case of deficient scrotal skin.
b. Sigmoid colon Vaginoplasty, it’s the procedure for patient who needs self-lubricated and more elasticity vagina. It’s a procedure of choice for secondary vagina reconstruction in case of post SRS-vaginal stricture.
7. Prevention of the deep vein thrombosis (D.V.T.), we use the Sequential intermittent compression sleeves (S.I.C.S) machine.
Expected course and recovery
Pre-operative
1. Following receipt of letters of recommendation and initial interview with the surgeon to determine appropriateness of SRS, a history and physical examination will be performed. The surgeon will explain the expected course and recovery period, risk and complication.
2. Genital electrolysis should be done prior to SRS. To prevent hair in and around their new vagina caused aesthetic and functional concerns. The patients should remove by electrolysis one to six weeks before SRS at the area showing in the picture.
3. The patients must be stop smoking 2-4 weeks prior the surgery because the effect of smoking to skin quality, wound healing and vascularity will be interfere the optimize results.
4. Patients have to stop feminizing endocrine therapy 2-4 weeks prior to surgery, medications affecting the coagulation cascade must be stopped 7-10 days prior to surgery. Prior consultation with an appropriate physician is required in the case of complicating medical factors.
Peri-operative
Patients are admitted and will undergo bowel preparation. To clean the bowel, the patient takes nothing by mouth prior to the surgery 6-8 hours. Blood will be drawn 20 cc. and EKG (electrocardiogram) will be obtained. A chest x-ray is taken. A pre-operative shaving will be undergone prior to their surgery.
Hospital staying will arrange 6-8 days and the patient will remain on bed rest restriction for much of this time. Analgesic controlled, anti-coagulants and antibiotic will typically remain on parenteral until the patient is mobile. Vaginal packing will be placed into the neo-vagina at the time of surgery and will be left in place for 5 days to ensure the flap will be well apposed to the inner vaginal walls in maximum dimensions. After this, foley catheter will be removed.
Post-operative care
Our nursing stuff will provide excellent post-operative care. After the surgery, they will perform the necessary care and do the dilation at least 2 weeks or until your departure this will be done twice a day. We recommend the clients to stay at a hotel close by our clinic as you are required to come to clinic twice a day for dressing and dilation.
Vaginal dilation
It is necessary to start to gently dilate your vagina two times a day, for the first couple of months, for about one hour each time, with an adequate amount of lubricant gel. The need to dilate becomes less frequent over time, particularly if you regularly engage in sexual intercourse. In case of no sexual intercourse after six months, the dilation for the vagina is needed twice a week.
The importance of dilation and post-surgical care
Dilation is the most important task you must do to ensure the success of your surgery. If you do not dilate responsibly, this can result in the shortening of depth and vaginal stenosis, including partial to total collapse.
Failure to properly dilate in the early stages can result in patients experiencing excessive vaginal pain at late times. In order to achieve more depth and to avoid vaginal obstruction it is very important that you follow the dilation.
You will be instructed on proper and gentle dilation technique after the vaginal packing is removed. Dilation is essential for developing maximum depth and ensuring post-op functionality of your vagina.
Sexual Intercourse
After the 3rd month post-op, you should be able to engage in normal vaginal. We recommend using gel as a form of lubrication. If you are healing well you can engage in intercourse after 2 months. In general, patients may engage in sexual intercourse after they get to dilator number 6.
Return to female hormones
Patients can resume taking female hormones in 10 - 14 days after the surgery but the need for hormones is less than prior to surgery, about 1/2 to 1/4 of preoperative doses. Before returning to hormones it is recommended that you check with our surgeon first. Our clinic director can assist you on what types and doses should be taken.
Medical Certificate
After the surgery, you will receive a Medical Certificate, given by the surgeon, stating that you have successfully undergone Sex Reassignment Surgery. It is of the client’s responsibility to provide us with the necessary information to be included in the certificate to meet the requirements of your country for legal purposes.
The process for legal name change and birth certificate amendments as well as other registered documents, is the responsibility of the client and it should be done in the client’s country according to its laws and regulations.
Possible risks and complications
1. Post-operative bleeding or Hematoma
2. Infection
3. Wound healing problem
4. Recto-vaginal fistula
5. Partial or complete flap necrosis
6. Intravaginal hair growth
7. Hypertrophic scaring