Concept of WIH's Non-penile Inversion SRS


Natural Looking Result of Female Genitalia from WIH's Unique SRS Technique

Led by Dr. Chettawut Tulyaphanich, MD, expert team of SRS surgeons, WIH International Hospital, is highly experienced and trusted in performing sex reassignment surgery (SRS) in one step construction by using the non-penile inversion technique. WIH's non penile inversion technique will provide gender reassignment surgical results that have the most correct anatomical appearance and physiological function.

For labiaplasty, WIH SRS surgeons utilize both penile and prepuce skin (a hood that covers the glans penis in non-circumcised patients or a part of skin between the neck of glans penis and the incisional scar in circumcised patients) to form the well-defined inner lip (inner labia or labia minora).

The constructed inner labia is normally pink in color and extends to the bottom of the vulva vestibule to become the posterior fourchette which is similar to the appearance of inner labia in biological women. WIH SRS surgeons create a natural shape of vaginal opening in vertical orientation for the best realistic look and function.

The vaginal opening can also expand appropriately to accommodate pleasurable sexual intercourse and vaginal dilators in varied sizes.

Excellent Depth and Function of Neo-vagina

WIH SRS surgeons spend unlimited time and carefully dissects the vaginal canal to achieve the maximum depth of vagina. An excellent 6 - 7 inches depth of the vagina can be expected even in SRS patients whose penis size is small and short.

Since the end of penile skin is no longer inverted inside vagina, the vaginal lining is made from only scrotal and/or groin skin graft which is absolutely hairless as a result of meticulous removal of all hair root during skin graft preparation.

Individualized self-lubrication can be also expected by preservation of specific secretory glands around the urethral & vaginal opening. The urethral orifice is set above the vaginal opening at the correct anatomical position to allow female pattern of urine flow.

All spongiosum (spongy) muscles around urethra are completely removed to prevent tissue engorgement during sexual arousal which can narrow the vaginal opening or cause difficulty during sexual intercourse.

Achievement of Special Sensation

Dr. Chettawut Tulyaphanich, MD, together with WIH SRS surgeon team, is well known for the ability to preserve specific sensory nerve to provide excellent sensation and successful achievement of orgasm even just within a short period of time after SRS. The neo-clitoris made from the dorsal part of glans penis is considered the primary sensate organ innervated by branches of pudendal nerve.

The part of vulva vestibule made from the ventral part of glans penis is considered the secondary sensate organ innervated by branches of pudendal nerve. Not only pudendal nerve, WIH SRS surgeons can preserve 3 more specific nerves which innervate the created sensate genital structures as follows:

- Clitoral hood and clitoral frenulum
- Inner labia and its frenulum (posterior fourchette)
- Vaginal wall adjacent to the intact prostate (G-spot area compared to biological female anatomy)

A clitoral orgasm differs from a vaginal orgasm because different sets of nerves are involved. The sex reassignment surgery lasts around 6 hours to complete all delicate processes, and Dr. Chettawut Tulyaphanich, MD, and team perform the surgery from the start to the end. All stitches are made meticulously to attain the best possible new genital structure with minimal scarring.