Removal of internal genitalia such as the uterus and ovaries is one of the most popular surgeries for trans men. Removing these organs decreases the production of oestrogen and other female hormones, and can also prepare the area for a possible phalloplasty or metoidioplasty at a later date.
WHAT IS FTM HYSTERECTOMY?
A hysterectomy and adnexectomy is the surgical technique by which the womb and ovaries are removed. The aim of this procedure is to avoid the effect of the female hormones produced by the ovaries, as well as the possible diseases that may settle in the female internal genitalia, which seem to be enhanced by the consumption of male hormones. It is also the basis for subsequent gender affirmation or gender reassignment surgery.
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BEFORE MTF HYSTERECTOMY
Who can undergo a MTF hysterectomy?
Any trans/intersex person who wishes to remove the uterus and ovaries to prevent the effects of female hormones, future illnesses or as a preliminary to gender reassignment surgery.
MTF HYSTERECTOMY SURGERY
Admission takes place on the day of the hysterectomy and the necessary monitoring is carried out in the hours prior to the surgery. In addition, the intestine and the area to be affected will be prepared for the procedure. This surgery involves a night stay in hospital at IM CLINIC.
TYPES OF MTF HYSTERECTOMY
The hysterectomy procedure
Hysterectomy and adnexectomy is performed under general anaesthesia and usually lasts about two hours. The IM Gender Unit medical team will perform this operation, choosing the most appropriate technique for each case. There are three basic ways to approach the operation:
- Abdominal route: This consists of making a small incision in the lower abdomen, which is then concealed by the pubic hair. From this incision, the womb and ovaries are removed.
- Laparoscopic: This technique requires three separate incisions, from which a gas (carbon dioxide) is introduced to swell the abdomen. After entering the abdominal cavity using laparoscopic forceps, the uterus and adnexa are removed.
- Vaginal route: This technique is very complex to apply in trans men and is discarded from the outset, as it is used in cases of patients with uterine prolapse or in extreme cases in vaginas that are very dilated due to previous births.
Using any of the three routes described above, the ultimate goal of total hysterectomy and adnexectomy (removal of the uterus and ovaries) is to access the abdominal cavity, separate the womb and ovaries from their attachment sites and blood supply with the final removal of both organs and careful closure of the abdomen.
THE POST-OPERATIVE PERIOD AFTER MTF HYSTERECTOMY
Returning home after a hysterectomy
The day after the operation, the patient can start eating and can get up and walk around. Staying in bed or stretched out for long hours may delay recovery and even cause complications. Approximately 72 hours after the hysterectomy, the surgeon may decide to discharge you from the hospital, but you will still have to rest and follow the instructions of the medical team.
For a few months, the area around the wound suffers heightened sensitivity that will gradually decrease. After a short time, the pubic hair grows back covering the area where the incision was made, leaving the fine scar completely hidden.
THE RESULTS OF THE MFT HYSTERECTOMY
After the hysterectomy, it is important that you follow all the recommendations of your medical team, such as medication and post-operative visits.
It is very important not to skip any of the post-operative visits with a member of the IM Gender team. Only they will be able to assess the evolution of the recovery from the hysterectomy. At all times, the patient will have access to a post-operative support phone number to resolve any questions that may arise, as well as a specialised physiotherapy service if desired.
IM GENDER team
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