Hysterectomy and Oophorectomy:
Hysterectomy and oophorectomy may be sought to reduce gender dysphoria. Hysterectomy and oophorectomy are gynecological procedures which can be performed by laparoscopic surgery (minimally invasive surgery) or open technique (abdominal hysterectomy)
1. Laparoscopic Hysterectomy technique:
The newest technique instead of a large incision to be a few tiny incisions are made through, which thin instruments are passed. This new technique significantly reduces scaring, pain, healing time, blood loss and duration of hospital stay when compare to open technique.
2. Abdominal Hysterectomy or Open technique:
A transverse incision is made through the abdominal wall, usually above the pubic bone, as close to the upper hair line of the individual's lower pelvis as possible, similar to the incision made for a caesarean section,approximately 4-5 cm. This technique allows doctors the greatest access to the reproductive structures and is normally done for removal of the entire reproductive complex. Abdominal hysterectomy is the most common method. The recovery time for an open hysterectomy is 4–6 weeks
3. Subsequently the vaginal or V technique:
Vaginal hysterectomy is performed entirely through the vaginal canal and has clear advantages over abdominal surgery such as less complications, shorter hospital stays and shorter healing time. When this technique has complications, a surgical exploration is required.
Vaginal closure and urethral lengthening:
This is the step where the part of urinary tract is altered and the vaginal is closed. It is because the direction of the female urinary tract is facing downward while the male urinary tract is in the front. Therefore the surgeon is required to alter the direction of the urinary tract and completely close the vagina. The length of the urethra is also made longer and prepared to join with the urethra at the fibula in the last step.
The surgeon will lop off the vaginal mucosa and fold it back outward and lop off the tissues in the vagina and to close it completely. When this procedure is completed the patients will not have a vaginal opening and the patient can urinate at the front direction, like that of a male but without the penis yet. The healing process takes about 2-3 weeks. The patient is required to stay in the hospital for 2 nights.
A catheter will be inserted for about 7-10 days. It will be removed after the urinary tract is healed.
Visit our gallery to view hysterectomy BSO before and after photo: