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Hysterectomy/Vaginectomy Basics
a year ago
Hysterectomy:
Removal of the uterus.
Laparoscopic, vaginal, and abdominal procedures exist and depend on individual anatomies and a surgeon's experience & preferences. A total hysterectomy also includes removal of the cervix, while a partial hysterectomy leaves it intact. If you intend to have a vaginectomy, your surgeon will require a complete hysterectomy.
Commonly paired with an oophorectomy and/or salpingectomy, but neither is a requirement for phalloplasty or vaginectomy, local laws and surgeon's personal requirements notwithstanding.
Oophorectomy:
Removal of one or both ovaries. Commonly performed simultaneously with a hysterectomy.
Some people choose to leave one or both ovaries during hysterectomy. This is generally fine and accepted by surgeons. Reasons to leave an ovary/ovaries may include future plans to harvest eggs (which can be done post-hysterectomy), or as a precaution against possible future inaccessibility to testosterone (to prevent osteoporosis and other side effects from not having estrogen or testosterone in one's body).
If you are at risk for ovarian cancer, your surgeon may suggest performing an oophorectomy. If you are not at any known additional risk, you may still have an oophorectomy, but be aware that new studies suggest that the most common ovarian cancers typically start in the fallopian tubes. You can have a salpingectomy performed and still retain your ovaries.
Salpingectomy:
Removal of one or both fallopian tubes. Commonly performed simultaneously with a hysterectomy.
Once a hysterectomy has been performed, there is no functional reason to keep the fallopian tubes, as their primary job is to deliver ova from the ovaries into the uterus. Given their recent developments highlighting them as a risk factor and originator for ovarian cancer, if you are getting a hysterectomy your doctor will likely suggest you perform a salpingectomy in tandem.
Vaginectomy, Colpectomy, Colpoplasty, or Colpoclesis:
The removal of part or all of the vagina. This can be done separately or simultaneously to phalloplasty, but it is recommended you consult with your intended phalloplasty/metoidioplasty surgeon beforehand if you wish to do both, and how they would prefer to stage things.
NOTE: Vaginectomy is not a universal requirement for phalloplasty or metoidioplasty. If you do not want a vaginectomy, be sure to bring this up with your surgeon during a consult. This is more of an issue if you require urethral lengthening due to a significantly higher complication rate. Every surgeon is different and have their own requirements, exceptions, and comfort zones; respect them, but find someone that respects yours too.
Colpectomy: A full vaginectomy - removal of the vagina. A risky procedure with a high, serious complication rate. The risk of hemorrhage, damage to the bladder and rectum are significant even with an experienced surgeon. The vaginal mucosa (lining of the vagina) is removed and the deep pelvic muscles are sewn together. Again, prior to having this procedure, consideration of the implications of future surgery should be discussed.
Colpoplasty: A newer procedure that involves closure of the external opening of the vagina whilst opening the internal (cervical) end into the abdominal cavity. This operation is less risky than a colpectomy but still preserves the vaginal mucosa. Vaginal cancer is therefore still possible. If such a cancer were to develop it would therefore go unnoticed and be difficult to get at. The risk of developing vaginal cancer is slight: one in a million.
Colpoclesis: Involves ablation (complete removal) of the vaginal mucosa and fusion of the muscular walls of the vagina. It is well tolerated with a low complication rate. Additionally since there is no vaginal mucosa, there is no risk of vaginal cancer.
A list of doctors willing to perform tubal sterilization, minimal/no questions asked:
https://docs.google.com/spreadsheet.....krb7Q/htmlview
+ a similar list from r/childfree (other states are parts 2-5) https://www.reddit.com/r/childfree/.....tors_part_one/
Removal of the uterus.
Laparoscopic, vaginal, and abdominal procedures exist and depend on individual anatomies and a surgeon's experience & preferences. A total hysterectomy also includes removal of the cervix, while a partial hysterectomy leaves it intact. If you intend to have a vaginectomy, your surgeon will require a complete hysterectomy.
Commonly paired with an oophorectomy and/or salpingectomy, but neither is a requirement for phalloplasty or vaginectomy, local laws and surgeon's personal requirements notwithstanding.
Oophorectomy:
Removal of one or both ovaries. Commonly performed simultaneously with a hysterectomy.
Some people choose to leave one or both ovaries during hysterectomy. This is generally fine and accepted by surgeons. Reasons to leave an ovary/ovaries may include future plans to harvest eggs (which can be done post-hysterectomy), or as a precaution against possible future inaccessibility to testosterone (to prevent osteoporosis and other side effects from not having estrogen or testosterone in one's body).
If you are at risk for ovarian cancer, your surgeon may suggest performing an oophorectomy. If you are not at any known additional risk, you may still have an oophorectomy, but be aware that new studies suggest that the most common ovarian cancers typically start in the fallopian tubes. You can have a salpingectomy performed and still retain your ovaries.
Salpingectomy:
Removal of one or both fallopian tubes. Commonly performed simultaneously with a hysterectomy.
Once a hysterectomy has been performed, there is no functional reason to keep the fallopian tubes, as their primary job is to deliver ova from the ovaries into the uterus. Given their recent developments highlighting them as a risk factor and originator for ovarian cancer, if you are getting a hysterectomy your doctor will likely suggest you perform a salpingectomy in tandem.
Vaginectomy, Colpectomy, Colpoplasty, or Colpoclesis:
The removal of part or all of the vagina. This can be done separately or simultaneously to phalloplasty, but it is recommended you consult with your intended phalloplasty/metoidioplasty surgeon beforehand if you wish to do both, and how they would prefer to stage things.
NOTE: Vaginectomy is not a universal requirement for phalloplasty or metoidioplasty. If you do not want a vaginectomy, be sure to bring this up with your surgeon during a consult. This is more of an issue if you require urethral lengthening due to a significantly higher complication rate. Every surgeon is different and have their own requirements, exceptions, and comfort zones; respect them, but find someone that respects yours too.
Colpectomy: A full vaginectomy - removal of the vagina. A risky procedure with a high, serious complication rate. The risk of hemorrhage, damage to the bladder and rectum are significant even with an experienced surgeon. The vaginal mucosa (lining of the vagina) is removed and the deep pelvic muscles are sewn together. Again, prior to having this procedure, consideration of the implications of future surgery should be discussed.
Colpoplasty: A newer procedure that involves closure of the external opening of the vagina whilst opening the internal (cervical) end into the abdominal cavity. This operation is less risky than a colpectomy but still preserves the vaginal mucosa. Vaginal cancer is therefore still possible. If such a cancer were to develop it would therefore go unnoticed and be difficult to get at. The risk of developing vaginal cancer is slight: one in a million.
Colpoclesis: Involves ablation (complete removal) of the vaginal mucosa and fusion of the muscular walls of the vagina. It is well tolerated with a low complication rate. Additionally since there is no vaginal mucosa, there is no risk of vaginal cancer.
A list of doctors willing to perform tubal sterilization, minimal/no questions asked:
https://docs.google.com/spreadsheet.....krb7Q/htmlview
+ a similar list from r/childfree (other states are parts 2-5) https://www.reddit.com/r/childfree/.....tors_part_one/
