Surgery was done in Motol Hospital, Urology department. Fully covered by insurance. Previously surgeries were done by Dr. Jarolím, now they are done by woman Dr. Fontana and other doctors/students. SRS is performed frequently here (Average 2 people per week), so the process has improved from just few years ago. Also this is 2-part surgery, 1st is the main surgery, then ~6 months later there is smaller surgery to pull skin over healed clitoris and stuff. Surgery was done with intent for maximum depth. Right now its still very swollen, I will make follow up post in few months about the progress.
Before surgery I was instructed to buy specific vibrator ("Gabriel") to be put in me for 3 days during healing after surgery and buy set of vaginal dilators (the one they recommend is great, its curved/ergonomic and from silicone) . I was recommended to get 2 auto-transfusions (2-3 weeks before surgery). Surgery was first set for beginning of December, but it got delayed to January. So I was only able to get 1 auto transfusions, because there wasn't personnel during Christmas. If you couldn't get any auto transfusions, its totally fine, you will just get blood from blood bank (if its even needed). Also I had to get preoperative examination from my general practitioner.
Sunday (Day before surgery)
- Make sure you have shaved down there, no need to epilate or anything, for me just razor shaving was enough. You can have a little hair there left there, because epilation is planned later on (before follow up surgery).
- Eventually one of surgeons asked me to come with them. I had talk with them in private, they explained the whole surgery in detail and answered all questions I had. I signed few documents there.
- I had breakfast before I came and after 12:00 I was forbidden to eat solid food, I got broth soup for dinner.
- I received strong laxatives through rectum 2 times - waited ~10 minutes then pooped...
Monday (Day of surgery)
- Usually woken up around 5-6 for medications and getting ready.
- I got to go as first of three patients, so I went around 8:00
- I was transported to surgery room, I think I had IV already and that they put calming medicines in me already by that point.
- They put measuring devices on me and talked to me a little
- Then they gave me breathing mask, after few moments anesthesia kicked in, I don't remember anything after.
- I woke up in my room (there is chance you may wake up at intensive care if they decide to keep closer watch on you)
- It was unpleasant pain, but it wasn't debilitating (depends on person)
- I was given painkillers through IV, which lasts for few hours, when I feel the pain coming back I just ask nurse for more.
- I shared a room with another trans woman who had the same surgery, but it took few days for us to start talking because we were both introverts lol
- For first night I couldn't receive sleeping medication because of being under anesthesia recently
Monday-Wednesday
- I had to be lying down for 3 days, liquid food only, until bandages were removed. This was probably the most difficult part, but you could lift your back and turn your body carefully to relax your back. I spent most of the time sleeping and watching youtube videos on my phone.
- I was only eating that broth soup which eventually became disgusting to me, so after asking for something else I was able to get cool fruity liquid snack.
- Doctors check you every day, one time I had small bleeding, so they had to change the bandages.
- During second night I received powerful opium painkiller, which was great because I didn't feel any pain during night and it helped with sleep.
Thursday
- Bandages were removed in morning and I was finally given solid food for lunch
- I was put on wheelchair first, transported to spa room in middle of hallway. I was instructed on how to dilate there. I had quick shower while on wheelchair. Then during next dilation I wanted to try showering while standing, however when I walked few steps, I became very lightheaded and my vision gradually turned dark. Nurse was there so I was able to sit down on wheelchair before I fainted. I woke up in next minute to nurses putting my feet up so I could get my blood back into my head. This can happen because were laying down for so long but my roommate didn't have problem with this (just dizziness but no faints).
Friday-Saturday
- During next dilation I walked across the hall and it seemed alright, but after dilation and trying to stand up again, I fainted again. I had low blood pressure during it. Then after my next dilation, where I was brought to spa by wheelchair, I managed to shower myself while standing but after that I got really dizzy and vomited my whole breakfast. I got short fever that was really unpleasant after that. This was finally solved by me getting transfusion (my own blood), after that I was able to walk without a problem. Doctors didn't think it was needed at first because I didn't lose that much blood but I guess it might have been an issue because I am skinny.
- After I vomited and was brought to my room, my dilators stayed in spa room and by evening it was gone. Nurses looked for it and couldn't find it. I wonder how it got lost lol. I had to use the big uncomfortable straight vibrator that I had after surgery. After I got discharged, trans woman from discord gave me better dilators that she didn't use, then I ordered same dilators that I lost because I liked them the most.
- My roommate had their wound reopen and they had to do quick fixing on it, she had awful fever and took antibiotics. This delayed her discharge to Wednesday.
Sunday
- This is day they discharged me home, also the day new patients would come in.
- I received discharge paper with instructions, I bought "Aescin" which is medication they recommend against swelling and used basic Ibuprofen painkiller when I was in pain at home.
- I was given few replacement bags for my urinal catheter, catheter removal was scheduled for next Monday (two weeks after surgery)
- I had my parents drive me home in car, I HIGHLY recommend getting inflatable ring cushion for sitting, they even sold it in hospitals pharmacy. If you don't have that try to put your weight on your back and least weight on your vagina (it's painful otherwise)
Two weeks after surgery (monday) I came to back for catheter removal around 7-8 AM. After it was removed I started using pads. Then I had to wait until I peed 2 times and report back then. Dr. Fontana herself inspected my vagina with sonar and gloves, gave me advice on dilating and answered my questions. I received paper with next instructions, I will go for checkup in 2-3 months.