I've recently had the privilege and the displeasure of going through SRS. Well, I'm still currently going through it as you'll see. Whatever the case, I thought it would be interesting to some other folks out there what the procedure has been like and what all has been involved. Naturally, all of this is quite specific to my particular locality, and also my particular, ~unique~ pile of trash that is my body.
Initiating the Process
Before SRS is even a possibility at all I had to get a "letter of indication" (Indikationsschreiben) from my psychologist. Getting this letter is prerequisite to receiving any kind of trans care in Switzerland. I was quite lucky in this case as I had a psychologist that's been with me for over a decade already, so I didn't have to hunt one down. Finding a psychologist, let alone one that isn't an ass about this particular thing, can be really tough.
Anyway, that letter then got sent off to the insurance, and then I had to get delegations from my house doctor for every treatment I wanted to undertake. So SRS, FFS, Logopedics, Lasering, HRT, each of those required a separate delegation from my house doctor to whatever specialist was responsible for that particular thing. Each of those also required a separate "cost coverage plan" (Kostengutsprache) from the insurance, which always took a lot of nagging from my part, and even then still more than a month to get. Really annoying!
In the case of SRS I had my house doctor send the delegation about a year ago, so around July 2023. I had him send a delegation to the University Hospital of Zürich (USZ)'s plastic surgery department, which is one of two places in Switzerland that offer SRS at all. I then got an appointment for a "pre-discussion" (Vorgespräch) in August, which got rescheduled to September, and then to October.
At the appointment I directly met with the surgeon that was going to carry out my surgery, and he asked me what I wanted to do and then explained the process, risks involved, etc. in quite a bit of detail. I voiced my desire for a ZDV (Zero-Depth Vulvaplasty) which means that they won't create a vaginal canal. Being ace I never had any interest in that anyway, and it's generally a safer procedure with less maintenance during recovery. Sounds good! Most hospitals won't even advertise this option, even though they can definitely do it, and even though it has a bunch of benefits. So if this sounds like something you'd like, make sure to inquire them about it. Note that even with ZDV they'll still scoop out about 5cm of depth, since there's quite a bit of penicular meat that's on the inside of your body they need to take out. However, without dilation post surgery that's just going to collapse again and grow together, so no biggie.
The surgeon then made it clear to me that they wouldn't be able to do the operation before I had completed a year of HRT, as that was the international standard. The rationale for this is that, since it is an irreversible operation, the patient should be sure of their decision. That makes sense until you consider that they don't impose the same kind of time constraint on any other operation either, not even ones that have a higher rate of regret than SRS. Fun.
Anyway, the surgeon was really nice and forthcoming, and pretty quickly moved to put together the cost coverage plan to send on over to the insurance. He also scheduled the "first discussion" (Erstgrespräch) sometime in January for me, and set a tentative surgery date for September 2024. He also informed me that at USZ at the time only one other surgeon was fully qualified to perform the operation, and my surgeon was, while having completed the training and performed before, not yet fully cleared to independently perform it. However, they would be pushing for getting that cleared up soon so that they could take on more patients. In 2023 they performed about 35 SRS surgeries, and wanted to double that soon since there was quite a bit of demand.
I then had to go onto the insurance badgering train until they finally approved the SRS. I also signed up for bottom lasering. Since the surgery uses some of your skin to form your future innards, it has to be as hair-free as possible. This procedure got delayed quite a bit, since the insurance was being an ass about it. Unlike face lasering, it's also apparently only done once every two months due to a different hair cycle. This made me worried that I wouldn't be able to get enough sessions in before the surgery, but the surgeon quickly clarified that it shouldn't be an issue.
At the first discussion the surgeon once again outlined the surgery plan and informed me about the potential risks involved in the operation. I then had to sign a bunch of paperwork, and that was about it. Now came the big waiting for September (with some lasering in between).
At least... that was the plan. Until on the 27th of June I got a call while out for lunch with friends. Apparently they had gotten a free spot for surgery on the coming Monday and wanted to know if I'd be up for doing the SRS then. Naturally I was a bit shocked and uncertain to do it on such short notice, but ultimately I decided to go for it rather than to put things off for even longer. After all, I'd been waiting to get rid of my hog for over a decade.
The Surgery
And so, in a hurry and rush I was checked into the hospital on Sunday afternoon. I had to drink some funny juice to empty my bowels and could only drink bouillon soup for dinner. I brought a bunch of food and clothes with me to the hospital, barely any of which I ended up needing. Before long it was off to sleep and the morning of the surgery arrived.
At around 8:15 my roommate checked in and a while later they shipped me off to get put under. I don't even remember falling asleep, I only remember waiting in a room with a bunch of other surgeons going about their business.
I awoke very drowsily. According to the clock on the wall it was about 17:00, which is a lot later than I had expected. Earlier they had told me I'd be waking up in the early afternoon. I wanted to let my family know, but I didn't have access to my phone and didn't feel like bothering anyone for it. An hour later after they checked that I didn't have any adverse reactions to the anaesthesia they carted me back up into my room.
First order of business was letting my parents know, who had apparently repeatedly called the hospital to ask about what was going on since I still hadn't replied. My roommate was also excitedly trying to talk to me, but I was far too drowsy to really want to say much of anything. I also instantly hated their voice, it was insanely twang heavy.
I don't remember much else of the day of, and my diary doesn't say anything else either.
The Hospital Stay
I was going to have to stay at the hospital for about a week, at least until Tuesday of the coming week. The first ordeal had begun! After the surgery they put a huge bandage on you that covers your entire bottom area. You pee through a catheter, and have a very strict diet of "build-up food" that apparently digests almost entirely, since you can't go to the toilet for a few days until the bandage comes off.
That much isn't so big a deal, but what really sucks is that you can't get up and shouldn't even turn onto your side at all. Lying on your back for four days straight reeeallly blows, especially if you're a side sleeper like myself. Your butt also starts to feel like it's been cast in concrete with the limited amount of movement.
Anyway, on the first recovery day I mostly slept. However, my roommate (who had also had SRS done at the same time as me) had a visitor. Listening to the two of them talk reminded me a lot of my primary and high school days, with the kinds of insipid conversations that I loathed. Having to listen to that was way worse than the pain from the operation. Seriously, I could go on for an hour about how shitty that roommate was, but I'll save you the tedium. Suffice to say that I can confirm that the worst part about hospitals are the roommates.
I also had to puke pretty badly during the night, which we later found out was due to a blood thickening agent they were pumping into me.
On Wednesday my parents came to visit, but I was still pretty zonked out. I also puked again until they removed that agent from my IV. The only other thing my diary mentions is that I wish I had waited until September. Maybe I would have gotten a less shitty roommate then.
That night was really bad for me as well. I somehow felt like I had to pee all the time and my legs started to shake pretty violently. The night shift care attendant (bless him) tried all sorts of things including flushing the catheter to see what was going on, but it was probably just psychosomatic. At some point I managed to pass out and sleep a little, but the time until then was harrowing.
They removed the IV on Thursday and in the evening I was able to eat my first real meal again. The hospital food wasn't great, and until then I had barely eaten anything anyway since I didn't have much of an appetite. My godmother came by as well for a brief visit, but I was still pretty zonked so I didn't have the energy to talk to her for long. Just one more day of bearing with this horrible roommate and they'd at least finally remove the bandage and let us walk about again.
Finally Friday arrived and they took the bandage off. We still had a catheter on, but it was switched to just a lil tube with a valve. The first time I tried to walk around I felt fine for about ten seconds before I suddenly broke out in a sweat and started to black out. Fortunately I managed to get back to bed before that happened entirely. Still, it's absolutely wild how you can feel completely fine lying down and go to a shutdown in the span of a few seconds. You really don't notice how badly your circulation is impacted by being stuck lying down for a few days.
I staggered to the toilet a couple of times, just to get my circulation back into gear. It took until Sunday for me to feel pretty normal again walking around, though. Some local friends also came to visit me that Friday and I already felt a lot better. It was fun to chat with them for an hour or two, especially after being so zonked out the past days.
The care takers taught us how to do the cleaning procedure of the nether region, too. It involved a lot of Betadine and produced a bunch of medical waste. I wasn't enthused to see what it looked like down there, but that was to be expected. Still bloody and swollen pretty bad at that point.
The night from Friday to Saturday was another horrendous one, this time courtesy of The Dreaded Roommate, who kept turning their TV back on with the screen pointed towards my bed and the headphones loud enough for me to still hear. I asked the night attendant three times to turn the TV back off when I noticed the roommate had fallen asleep, and each time they'd wake up again after a while and turn it back on. Absolutely aggravating.
On Saturday we were finally afforded the first shower in a week. It was exhausting, and I didn't even wash my hair. I also still hadn't shaved, and looked pretty dang disshevelled still. My mom brought me pizza for lunch, the first good food I'd had. Still didn't have my full appetite though, so I ate the other half for dinner. Had some more friends to visit in the afternoon and it really was a lot of fun to talk with them again. I had my laptop out to shitpost on Mastodon and read Yuri comics by that point, but it was still nice to just talk to people.
This was also the first time we did the cleaning on our own, though in my case they noticed that I was still bleeding a little bit. They'd have to keep an eye on that over the coming days. The cleaning itself wasn't difficult, just kinda weird and gross.
I was feeling better every day now and I could finally sleep a normal night's sleep again for once. Other than that Sunday passed by uneventfully.
On Monday they finally removed the catheter and I was able to go pee "normally". I gotta say, after spending your life conditioning yourself to absolutely have your hands down there and in control of the situation before releasing anything, suddenly having to keep your hands off took some mental gymnastics and felt really weird.
The care specialist also decided that they'd stuff some bandaging material to stop the bleeding in there and if it wasn't better by tomorrow I'd have to stay another day for them to cauterize the wound. Naturally that made me worried quite a bit since I really didn't want to stay in the hospital any longer than I absolutely had to.
Had another friend visit me and bring me more Pizza, which was very good. I also got some work done again! I know, I know, I'm supposed to be resting, but come on.
Anyway, on Tuesday morning they declared that things were fine enough and I could go home after all. Hooray! I had to be out of the room by 10:00 and slowly staggered down to the lobby with all my luggage. At first the plan was for my mom to come and get me once she got off work at 11:00, but sitting in the lobby on this weird ring cushion I had to use was far too uncomfortable so I decided to just take the public transit home.
Whew. Finally back home!
The Recovery
And so began the recovery process proper. I was prescribed a bunch of weak ass pain killers (Dafalgan and Minalgin) and sent a big ass box of materials for the cleaning procedure. I had to clean the nether region at least twice a day and every time I went for number two. And every time you do the cleaning you have to use sterile materials, so you accrue a ton of waste very quickly.
Anyway, things seemed pretty good, being home was a lot more comfortable, I had good food again, was able to walk about a bit and do stuff, and things seemed on the up and up. Cleaning wasn't a big ordeal, I had a nice summer dress that I could take on and off very quickly, and climbing into the bathtub for the cleaning kept everything quick and clean.
I finally got around to washing my hair on Wednesday, something I'd been pining for since I felt like it had started to smell pretty bad from having to lie around all the time for over a week.
But then on Thursday night the pain got quite a bit worse. I was still able to sleep through it, but it remained bad through Friday and the pain killers didn't help much. It felt like phantom pain, what with my body sensing the pain in a spot that wasn't there anymore. I still don't know if it actually was phantom pain, or if it was pain from a piece of tissue that was now inside of me rather than outside like it had been before.
I tried contacting the care specialist, but for whatever reason she didn't read her emails that day, and I was dumb enough to think I should just wait it off.
I couldn't sleep that night.
That Saturday we went to the ER of a nearby hospital. We had to wait around for about two hours only for the doctor to say it looked fine and that I could double the dose of Dafalgan and Minalgin, but that she wouldn't give me anything stronger. Great.
Well, I decided to just bear with it until the scheduled check-up on the coming Monday. It was hard to concentrate on much during the day, but fortunately I was able to sleep again. The suture was also bleeding again so I was worried that I was doing something wrong or that my recovery wasn't proceeding well.
At the checkup they removed the sutures that were still in and she gave me some MEDICAL GRADE HONEY to smear onto the still open wounds that were bleeding a little. She wasn't concerned about my recovery rate though and said to just proceed as before. Finally, she also prescribed me some Voltaren pills for the pain. Not exactly the strength I was hoping to get, but I'm a weak, shy idiot that can't push back.
Aside from the minor amounts of bleeding I was also oozing a weird kinda slime that was filling up the compresses I had to put on every time. I was worried about that but not sure what it was. The care specialist also didn't really know and recommended to just keep going.
At this point I was able to go for short walks for grocery shopping and such. I was still moseying around though and couldn't walk quickly or normally. I definitely noticed that I adopted a weird gait that wasn't great for my back. The pain gradually lessened over the days but I still couldn't sleep well. I started to feel mentally exhausted from all the lying about all day every day, but at least I was able to get some work done again, especially on a few projects I'd left lying about for ages.
Sleeping on my side slowly became bearable again, though still more painful than sleeping on my back. Still, it was just so much easier to fall asleep on my side that I wanted to do it even despite the pain. More painful than sleeping any position though was turning around, so I always slept fixed in one position, which is probably what contributed to sleeping badly. It also started to get quite hot outside, which never helps with sleep.
One curious thing was that ever since the operation I didn't have any mood swings anymore at all. The pain made me a bit grumpy at times, but I never felt actively depressed. At least... until about three weeks post-op. Apparently suspension of depression can be an after effect of anaesthesia. Interesting! My mood swing was about the usual stuff; feeling like I couldn't get done what I should and that I wasn't doing what I did well enough. You know. Read any of my previous entries to learn more if you haven't yet.
Around this time I also started getting increasingly distressed by how much that nether region smells. The ooze and the betadine residuals do not smell good at all. I have a pretty good sense of smell, so I could at times smell it even just lying down. Not fun!
During the fourth week post surgery I started gradually dropping the amount of pain killers I consumed. Which isn't to say I wasn't experiencing pain still, I just didn't want to chomp so many pills every day anymore and I wasn't sure how much they were helping me cope with things to begin with. Especially the Dafalgan.
But then on Friday I screwed up. I forgot to bring the seating cushion to my hair stylist appointment and had to sit on my bare ass for over an hour. That certainly did me no favours. The pain increased again, though now I'm no longer sure if it just did that anyway and my seating thing was a coincidence, or if it really was the trigger. Whatever the case, Saturday and Sunday things bled again a bit and the pain increased a bit.
Then I had my second check-up. The care specialist dug around a bit to see if she could figure out what was causing all the oozing, but couldn't really manage to see anything in specific. Probably some wound on the internal wall that was oozing a lot still. While she was digging around I started to sweat a bit. I chalked it up to pain, but when she was done and we were back to talking about medication for a bit I suddenly started to get really pale and almost blacked out. It felt similar to when I was first getting back up from the bed. Really bizarre!
I figure it was a delayed vasovagal response. Essentially my brain breaking down from all the unknown stimulus caused by her digging around. Absolutely wild experience. Obviously this all also irritated things again and I bled a bit more.
The pain also got worse again and got especially bad on the coming Thursday. Things did calm back down gradually after that, but even now, after almost six weeks, I'm still oozing, I still can't sit or lie on my side comfortably, still get random pain spasms, and overall it doesn't feel like my condition improved markedly the past two weeks. Though, honestly that's mostly down to the brain's inability for long-term thinking. If I actually graphed my condition out, there would definitely be an upwards trend, but it's hard to keep that in mind when you keep experiencing setbacks.
Six weeks post surgery my surgeon took a look at things as well. Just like the care specialist he couldn't identify a clear cause for the weird pus that's pouring out of me. He decided to put me on antibiotics for a week and advised me to more thoroughly wash out the area, to make sure all the pus got cleaned away. It seems very unlikely that I'll have enough of a miraculous recovery that I'll be able to return to work fully next week, but I'll try to keep things positive. It shouldn't take that much longer now. Apparently recovery is extremely different from person to person, anyway. A friend of mine had pretty much no pain or issues at all after returning home. I'm envious, I really am!
Fortunately by Saturday things finally showed signs of improving. I had far less ooze in the compress in the morning, and especially after the first cleaning and showering in the morning there was barely anything. What a relief! My stomach did complain a bit about the antibiotics, but it wasn't that bad.
But then... things didn't improve any further. I also bled quite a bit more and there was a weird white thingy that I found on Sunday.. At the checkup on Tuesday the surgeon took another look. Apparently the white thing I'd found was probably a piece of the foreskin that they'd use to attach the shortened urinary tract to the surrounding flesh. The urinary tract looked fine, no problems there, but I guess my body somehow rejected that piece of skin which caused it to come loose and open a wound. It's possible this is connected to the original cause for infection, but it's hard to say. The surgeon then chemically cauterised the wounds with silver nitrate (I think?) and sent me on my way with another new type of disinfectant cream to smear in places.
Of course, the cauterisation caused things to turn black and bloody and disgusting again for a few days, so I was dealing with that and a bit more pain again. But by Thursday it finally cleared up and by Friday morning I had barely any pus in the night compress anymore. Nice! On Thursday I also visited a physiotherapist to help with my increased need to go piss. At about two weeks post surgery I noticed that I had to go pee about every 2-3 hours, and especially sometimes woke up at night because I felt like I had to go, which wasn't great for my sleeping pattern. At least the sleep problem had already improved quite a bit in the interim, but I still had to go pee quite a bit more frequently than I was used to. The physiotherapist told me that this was very normal, and it was irritation around the urinary tract making it feel like I had to go more urgently than I really did. It would take some training and time to get used to suppressing that initial pee urge again.
She had me do a "pee journal" for three days where I had to record exactly when I drank how much and when I peed how much. That way we could get a better idea of the general rhythm and see if there was anything else that connected and could be used to help with the therapy.
The physiotherapist also advised me to immediately throw away that ring seating cushion I got from the hospital. She instead said it was much better to just use a big towel, roll it up, and form it into a sort of crescent moon shape to sit on. That should balance the weight much better, and at least on a trial run it seemed more comfortable than the ring, which never seemed comfortable at all no matter what I tried.
Though by then I was also already trying to get used to sitting normally again anyway, and I could manage as long as I remembered to shift and stand up regularly. Phew. Finally things were actually looking up! Still, I decided I wasn't going to return to work for at least the rest of the month anyway, so that's at least two full months of not being able to go back to the office. Mind you, I still did quite a bit of work from my chair at home, but it definitely didn't feel like I was actually back to work at all.
The situation kept improving from there, and by Saturday there was barely anything left in my compress and I was able to sit again for hours on end. I finally got to go back to my favourite weekly Saturday meetup, Zürindies, and started to feel like an actual human bean again. Nice!
The checkup on Monday also went without a hitch. Apparently the wound in the interior healed up nicely, so all that was left now were the two exterior wounds at the bottom that started because the sutures opened up a little. The care specialist treated them with more silver nitrate, and told me to get back to using the scar treatment cream. I could stop doing the flushing and washing though, so that's another chore off the list, very nice!
And that brings us to today. I've been dragging out publishing this article for long enough, and I think I'll rather make another entry at a later point to recount any further updates than make this one even longer than it already is.
Conclusions
And so, after two months, many doctors and care specialists, tons of medical equipment, and thousands of francs my SRS journey finally came to a close for the most part. Mind you, they said it takes around 6 months for things to fully heal up and I can't go swimming or anything like that until then, so it isn't over for good, but I can get back to business as usual now.
After reading the draft versions of this article a few people asked me if I had had any doubts or regrets at any point. Apparently the descriptions here were sufficiently scary for them to worry about that, but honestly, for me, the thought never even occurred once. Sure, the recovery and treatment sucked, it wasn't pleasant, but it was always just a matter of getting through with it, not something that I ever wished I could go back on. Then again, given that I've wanted to be rid of this piece of shit part of my body for over ten years, it shouldn't be a surprising outcome at all.
What is surprising to me however is just how consistently constant the boost to my mood has been since the surgery. Granted, I think a part of that also comes from me being able to indulge myself and not having to work, but it would be folly to attribute the massive decrease in the frequency of my mood swings just to that, too. I also sometimes feel a sense of relief washing over me when I realise that I'll never have to deal with a gross piece of flesh dangling between my legs and sometimes rearing its disgusting head against my will. It's very nice.
I was also honestly surprised at how forthcoming and nice all the personnel was that I interacted with. Doctors, surgeons, care specialists, all of them were very nice and accommodating. I never once felt like I was being mistreated or neglected. Sure, there were some problems with scheduling, and perhaps the antibiotics should have been pulled out sooner, but those are issues that I can easily attribute to other factors.
A big thanks to everyone who tended to me and put up with me, to all of my friends who visited me and lent me their company, and to my family for supporting me throughout all of this mess!
If you have any questions that weren't covered by my writing here, or you'd like to talk to me about anything at all, my contact details are prominently featured on my webzone!
Update, Sunday 10.11.2024: Some weeks ago I had a checkup with the head surgeon. Since the wounds at the bottom still weren't healing right despite various treatment attempts, he thought it was worth going back into surgery to fix the region. And so I did last Wednesday. It was only under local anaesthesia, and didn't take very long. I was lying on my back, and my legs were put onto elevated cushions so I was constantly in a sort of manspreading sitting position, but lying down. Weird. Anyway, the anaesthesia was a bit painful, a couple of pricks, but the rest wasn't painful at all.
They washed everything out thoroughly and then scraped it off as well. Then the surgeon cut open the region that formed a sort of... pocket. Apparently the skin was badly folded over, and the entire pocket was "outside skin" which is why it wasn't healing shut right. He then sewed things shut again and that was that. I was ferried back off to a waiting area to recuperate for a few minutes (and they brought me a drink and a croissant, how nice,) and then was allowed to go back home. I'd have to do some more washing of the sutured area after pooping again, but that was nbd.
The whole thing coincided really nicely with my FFS, for which I was put onto antibiotics again for a while, which already reduced the amount of oozing drastically. Since this corrective operation I haven't had any ooze at all anymore, too, just some bleeding, which is to be expected for now. I have another appointment in two weeks to remove the sutures, but I expect that things are going to go swimmingly from here.
Update, Tuesday 14.01.2025: The correction healed up nicely enough and I haven't had any wounds or complications from that since. However, the weird secretions/pus still hadn't ceased, so I was scheduled for another appointment with the head surgeon today. His diagnosis was that this isn't caused by a bacterial infection, but rather by skin irritation instead. He thinks it's likely that the scrotal skin of the outer labia being folded and squeezed together all the time is irritating it. So they're going to remove the excess skin that's still hanging out there.
Which is great news to me, that skin's been a bother all along, especially while peeing and so on, since the stream sorta sticks to the hanging skin. Anyway, this means another minor surgery under anaesthetic, and that means another round of insurance approval fun times. I figure it'll be a month or more until the actual surgery takes place. Recovery should be pretty simple though, just a bit of treatment to prevent scarring like before. I'm excited for it, and will update again once it's taken place.
Update, Wednesday, 02.04.2025: The surgery took place yesterday, that's right, on April first. I had to show up at 6:30AM to get checked in, got put under, and then awoke around 10, I think. However, even though this was supposed to be a simple procedure that I could go back home for afterwards, things turned out a bit more complicated this time.
During surgery they discovered a fistula that had built up near the urethra, which they had to... remove? I'm not sure what the exact procedure was. There also was a small cavity below the urethra into which liquid could spill, which is probably what caused my problems urinating. They re-attached the urethra to the skin, so the cavity should be gone as well. For both of these procedures to work they had to insert a catheter however, which would have to remain for two weeks for things to heal up nicely.
Because of these complications, they asked me to stay a night for observation. I reluctantly agreed, staying in the hospital had so far never been a pleasant experience, especially during the nights. However, after a long wait for a bed, I was very lucky to be put into a small room with no other occupant.
Ah, what bliss to just have some silence. I was still pretty zonked out from the anaesthetic, so just being able to snooze the rest of the day was nice. My mom came to visit me in the evening, as did the surgeon and the care specialist, who explained the discharge procedure and what I would have to do after.
I didn't have much of any pain all day, just some stinging pain every now and again which I think just came from the catheter. I was honestly surprised at how little pain there was, given that they did do quite a bit of cutting and stitching. This time I also didn't feel nauseous from the anaesthetic anymore, just tired. As before I couldn't just sleep through the night and kept waking up intermittently.
Around 2AM someone else was admitted to my room as well, though aside from some very brief and quiet snoring it was so far the most pleasant roommate I'd had. Still, I suppose no hospital stay without snores yet!
Anyway, next morning the bandage was removed and the catheter changed for one with a valve so I could just discharge into the toilet with it at home without having to carry a whole bag with me everywhere. Still... two weeks, huh. A bit longer than what I expected to be dealing with this stuff. I initially thought I'd just have to go back in a week to get the sutures removed.
I can only pray that this finally fixed all the problems. Honestly the surgeon and care specialist were similarly apprehensive, since they never truly identified the cause of the weird ooze. I guess we'll just have to wait for now.
I suppose there'll be yet another update in two weeks-ish when the catheter is out and the sutures removed. For now I have to repeat the annoying cleansing/washing procedure from before at least twice a day. Not thrilled about that or the catheter, but oh well~ I've survived worse.
Update, Tuesday, 08.04.2025: Two days ago in the evening I noticed some blood in the compress near one of the upper sutures. I also noticed it oozing out very slowly as I went to the toilet that night, but I just hoped it would fix itself. The next morning on Monday there wasn't much blood in the compress, but it was still oozing just as slowly. I once again hoped it wouldn't amount to much and went on my day as usual.
Then in the evening, as I went down to the kitchen to check on my sauce, I suddenly noticed being rather warm around my crotch. My first thought was that the catheter had leaked, so I checked, only to find that the compress was soaked red. Then I noticed I'd been dripping blood all over the kitchen floor. I ran back upstairs, grabbed my phone, undressed, and climbed into the bathtub. By this point it was dripping quite quickly. I grabbed a compress from nearby, rolled it up, and pressed it on the leaking wound.
Next step would be to call the doctors, but I didn't have a clear number, so I had to google for one with my phone while still holding down the compress with the other. I found an emergency number of the hospital's plastic surgery department and called. I was quickly directed to another doctor, who frantically tried to direct me to write an email, since he wasn't at his desk at the moment. I reluctantly agreed, and then tried to one-handedly take useful photos, which is hard to do of this area even two-handed.
By that time a little pool of blood had formed and was coagulating on the bathtub, but I managed to compose a short email with the necessary attachments. At this point my parents arrived at home, who could then hand me the supplies I needed to clean the wound. Fortunately the compression had managed to mostly still the flow of blood, so while it looked gnarly, the worst of the emergency was over.
Once cleaned up there were two areas that still bled a bit, both on the left side, one at the top suture, and one at the bottom, below the urinal tract. I once again compressed it after taking and sending a photo. The doctor called me back soon after, and after another frantic and shouty exchange he advised me to go to ER. They'd take a look at it there. My mom was gracious enough to drive me up there real quick, but even when I arrived at 1800 the waiting room was suspiciously full. I quickly signed up as the doctor had already registered me, and went to sit down.
A few minutes later my surgeon ran by in casual wear. He had just clocked out and went to see me real quick (bless that man, seriously). He chatted with the ER reception so he could go to a side area and have a quick look at me. He said that in the best case scenario it was just an internal vessel that unblocked or something, and with some pressure it would calm down again. He then hastily made a better bandage that applied some pressure to the area, and then went on his way again. I didn't want to hold him up longer either, guy's busy enough as it is and deserves his rest.
What followed were three hours of waiting, with the room only filling up with more and more patients, and no ER spaces ever coming free. The only people they saw were those with bone fractures or similar, I'm guessing because they have different personnel to treat those cases. Even some people that were brought in via ambulance were left out on their carriages in the waiting room. No idea still what the heck was going on that night to hold everything up, but after those three hours of live-tooting my boredom I decided to go back home. Right as my mom was on her way to get me, they called me up to... take a blood sample. The nurse still couldn't tell me how much longer I'd have to wait. Cool! So I just went home immediately after she was done lol.
I had a little bit of the dinner I'd prepped hours earlier, sent an email to my surgeon and care specialist to ask what to do next day, and then went to sleep. Just as I was brushing my teeth I got a call from the plastic surgery department. I guess now would have been around when I would have gotten my turn lol. They asked me if the compress was wet, which it was not, apologised for how bad the ER had been that day (according to them a very unlucky draw), and told me to get in contact with the care specialist again the next day. As before and always, all the people I've ever spoken to from the plastic surgery department have been exceedingly nice and caring, which really goes a long way towards forgiving the other kinds of problems I've had to suffer.
Anywho, in the morning I finally removed the bandage, cleaned the wound, and took some more photos. It was still bleeding a little bit, but very, very slowly, kind of like it had been on Sunday evening. The care specialist called me to set up a visit tomorrow at 10, and told me I didn't have to check in again unless the bleeding suddenly got worse again.
As I'm writing this it's now afternoon and it was bleeding very slowly again when I had to go to the toilet for number 2. After cleaning again I remained in the bathtub for a good while to let it air out. It was not bleeding anymore, and the swelling had gone down considerably from yesterday.
Still, I had to cancel my therapy session this morning and the apartment visit I had planned for tomorrow, which sucks. Of course, having to lie down and try not to move much also sucks a lot, but I can deal with that a bit better than the rest.
I guess we'll see how things are tomorrow. If nothing substantial happens, which I pray for, I won't update this again until the planned update on Tuesday next week. As always, if you're curious about more live updates, check my Mastodon.
Update, Thursday, 17.04.2025: Alright, I had the checkup on Tuesday where they removed the catheter and the sutures. What a relief!! You really have no dang clue how nice it is to finally be able to pee normally again. Good lord.
Over the days prior to the checkup I'd also experienced a bit of that phantom pain again that I had experienced about two weeks post the initial surgery, too. I figure that's just more neurological stuff from my brain being confused about the missing skin. It mostly popped up if I walked around quite a bit, though it wasn't anywhere near as bad as it was before and I managed fine with the painkillers.
Anyway, now with the catheter gone my discomfort and general mood has improved considerably and I'm feeling much better. I still need to continue washing and treating the wounds for a bit longer, but the bleeding from the suture has also finally stopped now that the sutures are actually out.
The surgeon also took a look on Tuesday and he was still a bit worried about whether the urinal tract was healing properly. He couldn't quite get a good look at it, and did find some red spots, but wasn't sure if that was the fistula that had to be removed, or a hypergranulation (excessive skin reformation). I'm supposed to check if the pee comes out of the right place now, but I'm honestly still not sure how to do that short of trying to do it in the bathtub with a mirror.
I haven't done that yet and at least so far peeing has been quite fine. There's a bit of a spray still, but nothing bad, and the issue from before is gone too; I no longer have to hover my butt for a bit for the last bits to drizzle out.
The ooze has also stopped since the surgery, so the primary issue that they meant to solve with it seems fixed, too! Hooray!
So yes, unless something new develops, this will really, finally have been it. Phew! Also, I just want to say, everything looks a lot better now than it did initially, too, in an aesthetic sense. The surgeon did a good job fixing it up.
I have another checkup in two weeks, but I doubt there'll be more to report then. So yes, finally, the true ending of this story, and I can put this article to rest. If you've read it all and kept up with the updates: thanks! I hope it gave you some insight into the general procedures involved.
At this point I do want to stress though that this is just my experience, and while it may seem harrowing to read it described like this, it really is not that bad in practise, and I haven't regretted doing any of this for even a nanosecond. I regret that things didn't go perfectly smooth, but that's just the luck of the draw. I'm happy with the care I've received at USZ, and I'm thankful for everyone that has tended to me, and beyond grateful that I was given the opportunity to do this, and so soon at that.
The comfort I have with my own body has improved drastically, and while there's still a myriad of psychological issues that I have to sort through (as evidenced by other entries on this here blog), in general I think anyone that has known me, whether offline or online, should be able to attest that I'm doing a lot better already. SRS is only a part of the reason for that improvement, but it is a big, big part.
What I want to say is: if you've considered SRS before and this article has put you off of it, I urge you to reconsider. It can be hard to imagine what life is like after such a big change, and I guess many do not have the same level of conviction as I do, so perhaps think of it like this: when you are stuck down in a well, in the oppressive darkness, it can be hard to imagine how warm it is outside, how free it feels. It can be impossible to imagine you'd ever get of it, and any attempt to even do so seems futile and dangerous. But once you're out, the inverse is true as well: it is hard to remember just how bad it was down there, and impossible to explain why you didn't climb out sooner.
