FTM Hysterectomy / Bilateral Salpingo-Oophorectomy (BSO) in Bangkok, Thailand
WPATH considers hysterectomy with and without salpingectomy/oophorectomy to be a necessary component of gender-affirming surgical therapy for transmen who choose to seek this procedure. Hysterectomy has been successfully combined with other gender-affirming surgeries performed in the same operating suite, including vaginectomy, mastectomy, and genital reconstruction, such as metoidioplasty or phalloplasty. Kamol Cosmetic Hospital provides FTM hysterectomy 4 techniques as follows below;
1. Laparoscopic technique
Instead of making a large incision, the new technique makes only a few tiny incisions through which thin instruments pass through the abdomen. This new technique significantly reduces scaring, pain, healing time, blood loss, and the duration of hospital stay compared to the open procedure.
Picture 1 shows the scar of the laparoscopic hysterectomy technique.
2. Abdominal Hysterectomy with Bilateral Salpingo-Oophorectomy (BSO) or Open Technique
A transverse incision is an abdominal wall, usually above the pubic bone, as close to the upper hairline of the individual's lower pelvis as possible, similar to the incision made for a cesarean section approximately 4-5cm long. This technique allows the surgeon the most exceptional access to the reproductive structures and performs the removal of the entire reproductive complex. Abdominal hysterectomy is the most common method. The recovery time for an open hysterectomy is 4–6 weeks.
Picture 2 shows the scar of an abdominal hysterectomy or open technique.
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 fewer complications, shorter hospital stays, and quicker healing time. If this technique is complicated, surgical exploration will be required.
4. Natural Orifice Transluminal Endoscopic Surgery Hysterectomy with Bilateral Salpingo-Oophorectomy (BSO) & Oophorectomy or NOTE technique
A new technique removes the uterus and ovaries. They were developed from total laparoscopic hysterectomy and transvaginal hysterectomy procedures, which provide more safety. The surgeon inserts a vaginal speculum into the vagina and inserts the shield into the vagina to protect the cervix. Then the surgical instrument is inserted into the vagina. After dissection, both uterus and ovaries are removed from the vagina opening.
Picture 3 shows the process of the NOTES technique Hysterectomy.
Advantage of Hysterectomy NOTE technique
- No scar
- Less postoperative pain
- Shorter hospital stay and quick recovery of bowel function
- Shorter recovery and faster return to daily activities
- Less complication from bleeding during surgery or less chance of injury in the abdomen
Preparation for Hysterectomy Surgery
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Gather information. Learn as much as you can about having a hysterectomy. Make sure you understand how the procedure will go and what is involved in the recovery process.
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Lose weight if you’re overweight. Being overweight can increase the risks associated with surgery and anesthesia, and severe obesity can increase surgery time and blood loss. If you’re overweight, talk to your doctor about the best way to go about losing weight before your surgery.
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Stop smoking. Stopping or cutting down on smoking as much as possible can help with general anesthesia and recovery from surgery; smokers may have problems breathing during surgery, and they tend to heal more slowly afterward.
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Discuss your medication with your doctor. Talk to your doctor about whether you need to change your usual medication routine before having a hysterectomy. It would be best to inform your doctor about any over-the-counter medications, such as aspirin or dietary supplements. Some supplements can help prepare you for a hysterectomy. For example, taking a daily multivitamin can help improve general health, and vitamin C can help promote healing. Talk to your doctor about recommended supplements you might take before your hysterectomy surgery.
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Make sure other medical conditions are well-controlled. If you have diabetes, high blood pressure, sleep apnea, or other medical conditions, check with your doctor to make sure they’re under control before you have a hysterectomy. When other pre-existing conditions are managed,
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Eat light. Limiting heavy foods and avoiding big meals can help you feel better before and after the procedure. “Eating healthy is always important, but even more so when you plan to have surgery.
Post-operative Care for Hysterectomy
Recovery for Hysterectomy Surgery
Risks and Complications for Hysterectomy Surgery
Before and After for Hysterectomy with BSO
Picture 3. Shows the scarless of a NOTE technique
Frequently Asked Questions (FAQs)
A: An FTM hysterectomy is a surgical procedure that removes the uterus and sometimes the ovaries and fallopian tubes in female-to-male transgender individuals. It's a significant step in gender affirmation for many, as it eliminates menstruation and reduces the production of female hormones. This can help alleviate gender dysphoria and create a physical experience that aligns more closely with a male identity.
A: People choose to have the procedure for various reasons. Primarily, it helps align their body with their gender identity. Removing the uterus stops menstruation, which can be a source of dysphoria for transgender men. Additionally, removing the ovaries reduces estrogen production, which can further aid in masculinization.
Some individuals may also choose this surgery to reduce the risk of certain gynecological cancers.
A: There are several approaches:
- Vaginal Hysterectomy: The uterus is removed through the vagina, leaving no visible scars.
- Open Hysterectomy: This involves an incision in the abdomen to remove the uterus.
- Laparoscopic Hysterectomy: Small incisions are made in the abdomen, and the uterus is removed using specialized instruments and a camera. This typically results in less scarring and faster recovery than an open hysterectomy.
- Robotic-Assisted Laparoscopic Hysterectomy: Similar to a laparoscopic hysterectomy, but with the added precision and dexterity of a robotic surgical system.
A: Yes, Kamol Hospital offers scarless laparoscopic hysterectomy for transgender men. This technique involves removing the uterus through the belly button, leaving no visible scars. It's a minimally invasive procedure that can result in less pain and faster recovery compared to traditional open surgery.
A: Kamol Hospital is a leading provider of gender-affirming surgeries, including hysterectomies for transgender men. Here are some of the benefits of choosing Kamol Hospital:
- Experienced Surgeons: Our surgeons are highly skilled and experienced in performing hysterectomies for transgender patients.
- Advanced Techniques: We offer the latest surgical techniques, including scarless laparoscopic hysterectomy.
- Comprehensive Care: We provide holistic care that addresses both the physical and emotional needs of our patients.
- Modern Facilities: Our hospital is equipped with state-of-the-art facilities to ensure patient safety and comfort.
- Affordable Prices: We offer competitive prices for our high-quality services.
A: After the procedure, you can expect some soreness and discomfort in the surgical area. You may also experience some vaginal bleeding. These symptoms are usually manageable with pain medication and should improve within a few days. You'll need to avoid strenuous activity and heavy lifting for several weeks to allow for proper healing. Your surgeon will provide detailed post-operative instructions to ensure a smooth recovery.
If your ovaries are removed during the procedure you will likely need to take hormone replacement therapy to maintain hormonal balance. This typically involves taking testosterone to continue the masculinization process and support overall health. Your surgeon and endocrinologist will work together to determine the most appropriate hormone therapy regimen for you.
A: A hysterectomy removes the uterus, which is where a fetus develops during pregnancy. Therefore, you will not be able to carry a pregnancy after a hysterectomy. If you desire to have biological children in the future, you may want to consider options such as egg retrieval and freezing before undergoing the procedure.
A: The recovery period varies depending on the surgical technique used and individual factors. In general, you can expect to return to light activities within a few weeks. Full recovery may take several weeks to a few months. Your surgeon will provide specific guidance on your recovery timeline and when you can resume normal activities.
A: While hysterectomies are generally safe procedures, there are potential risks and complications, including:
- Bleeding
- Infection
- BleedingDamage to surrounding organs
- Adverse reactions to anesthesia
These complications are rare, and our experienced surgeons take every precaution to minimize risks.
A: Your surgeon will provide detailed instructions on how to prepare for your surgery. This may include:
- Stopping certain medications or supplements.
- Fasting for a certain period before surgery.
- Arranging for transportation and support after surgery.
A: The cost of an FTM hysterectomy at Kamol Hospital varies depending on the surgical technique used and individual factors. We offer competitive prices and transparent pricing policies. You can contact our hospital directly for a personalized quotation.
A: We encourage you to contact us directly with any further questions you may have. Our friendly and knowledgeable staff are available to provide you with the information and support you need to make informed decisions about your care.
