SRS

The penis is around 6 to 7 inches and this much deduction to create the vagina is not right. Just 3 to 4 inches is used to create the labia minora, clitoris, and clitoris hooding. Moreover, the problem is sexual intercourse is not satisfactory. Dr. C Vijay Kumar makes sure the penile inversion is carried out in several steps so that the best results are achieved. Initially, the emphasis is put on creating that genitalia which has the right fetal tissue base & the actual difference is noticed between the male & female outer genitalia. The surgical approach helps in making sure the vaginal depth is right. For the first time if the vaginal depth is not achieved then the doctor will suggest you get the sigmoid colon vaginoplasty which helps in creating the vagina:

• Sensitive
• Lubricating
• Naturally deep

If penile skin is not enough to create the desired vaginal look and sometimes there may be a problem with a skin graft. Normally, there is a need for at least 4 to 5 inches of vaginal depth to get that desired result. But, if the skin graft is not right or there is any other issue then the further process can go wrong. Such situations demand higher revision surgery. So, what’s the choice?

• Full-Length & thickness scrotal skin graft SRS: Here the main purpose is to address all the earlier issues and ensure the desired results are achieved. This is where it came to light penile skin and preputial skin has to be there for creating the vulva parts. Moreover, it will be easier to create enough vaginal openings. This surgical approach discards the use of penile skin & simply uses the full length & full thickness of scrotal graft which helps in creating the vagina. All in all, this approach has allowed us to address all sorts of cosmetic issues.
• Sigmoid Colon SRS: The sigmoid Colon vaginoplasty approach addressed the need of not having enough skin grafts. The results of the same led to a sensate vagina, lubrication to the desired level, and deep enough as to what it is naturally. But, there was problem in this type of approach like:
  • Excess & prolonged vaginal discharge
  • Dilation is required for a long time
• Advanced Sigmoid SRS: In the MTF sex-change surgery, the advanced approach gives better results. During the advanced method, the penile skin is used to get a wonderful look which means the required penile skin will be used. The latest approach allows the area to have proper sensibility as to what is needed. The results of the same can be noticed through the approach that the vagina is around 7 to 12 inches deep and it has all the necessary features of the natural looking vagina. Additionally, masturbation and sexual intercourse can be done properly. All in all, the excessive secretions problem is even addressed. Its superior results and overall experience are worth every sense to get it done.

The factor of cost can vary from person to person considering their demands on which transition process they need to get, the medications prescribed by the doctor, and therapy.

Step 1: Making the necessary Marking & Infiltration
The surgeon will make the necessary incision lines along with infiltration & then an anesthetic solution is applied. Its application will help to numb the tissues which will limit the total amount for which it needs to be used. The procedure will allow the blood vessels to get contracted & then blood loss is reduced.
Not just everything is manageable but recovery time is also easy. Additionally, the neurovascular structures are blocked like pudendal vessels, scrotal area, and the spermatic cord gets better.
Step 2: Scrotal Skin Dissection
The incision is made on the vertical central scrotal incision. Additionally, the triangular scrotal flap is then elevated and dissection of the urethra is done. Lastly, the scrotal skin graft is planned and then the necessary skin will be kept apart. The below penile skin is preserved which allows the healing to be proper.
Step 3: Orchiectomy
The testicular tissue will make the scrotal tissue separate which allows the cord to be free. The necessary fat will be there which allows the blood supply to be proper. After that, the lateral scrotal tissue and fat will be there to make the necessary area preserved. If the patient is skinny then spermatic cords are used which allows the necessary structure to be formed.
Step 4: Dissecting & taking out the inventing muscles
From both areas, bulbocavernosus is removed and this is the reason appearance will be better. Hemostasis will make sure everything is right and then necessary hemorrhage is done. Make sure to prevent the injury as this way bleeding will not be there.
Step 5: Urethral separation from corpora
Around 3 inches of the proximal urethra is taken & then comes the distal part. While dissection is being done the neurovascular and urethra pedicle should be avoided.
Step 6: Penile skin degloving
This process requires utmost care to ensure the dorsal neurovascular bundle is removed safely. Doing so will make sure the orgasm is achieved and clitoral sensation is maintained.
Step 7: Dissection of Glans and preputial island flap
Then comes the upper part & the inner skin flap is left in the skin flap. The part of dissection requires utmost care, and this way blood & nerve supply is rightly maintained. If any injury occurs then the chances of having loss of sensation increase. So, this step is crucial to have the best results.
Step 8: Creation of Clitoral hood, Clitoris, & Labia (clitoroplasty, labiaplasty)
At this point, a clitoral hood is made. Then the flap is positioned in the necessary location, and further construction is done. Then the namaste position is made which allows the scrotal skin to get stitched.

For many people, the road of transgender might be easy and for some, it might be tough. Dr. C Vijay Kumar expertise, knowledge, and approach towards the patients make everything seem much easier. On average, the SRS surgery cost is between:

• Male to Female surgery: Rs 2 Lakh to Rs 5 Lakh
• Female to Male Surgery: Rs 4 Lakh to Rs 8 Lakh

The factor of cost can vary from person to person considering their demands on which transition process they need to get, the medications prescribed by the doctor, and therapy.