Sigmoid Colon

PAI (Preecha Aesthetic Institute), we are following WPATH/HBIGDA or SOCs or Asia PATH.

The Standards of care for gender identity disorders – WPATH (World Professional Association for Transgender Health) the earliest sets of clinical guidelines for the express purpose of ensuring “lasting personal comfort with the gendered self in order to maximize overall psychological well-being and self-fulfillment.” These standards are still the most well-known; however, other sets of SOCs, Asia PATH protocols and guidelines do exist, especially outside the USA.

Requirement & Good Candidate for Sigmoid Colon for Male to Female surgery at Preecha Aesthetic Institute

• Specific minimum requirements as prerequisites to HRT
• Much of the criticism surrounding the WPATH/HBIGDA/Asia PATH
• Psychological evaluation letter by qualified mental health professional
• Highly controversial and often maligned document among patients seeking medical intervention (Hormones) unless there is contraindication or the patient is unwilling to
• Real-Life experience
• Physically healthy and emotionally stable with realistic expectations
• Must be over 18 year old with good health condition with parent. Fully 20 year is able to come by yourself
• Good health conditions
• No HIV+ 
• Body Mass Index (BMI) must less than 24.99 by open technique and laparoscopic must less than 21.00 on medical health checks
• No previous surgery around waist area (tummy)

Pre op Sigmoid Colon / Primary Sigmoid Colon's guidelines

1. Take light meals 3 days before surgery date. No vegetable 3 days before surgery date. More instruction will give right after direct consultation.

• No Vegetables even well cook.
• No food with high fiber (grains, cereal and pasta, fruits, legumes, nuts and seeds, vegetables)
• No junk foods such as hamberger, French fries.

To eat:

• Clear soups
• Well cook from pork, fish and beef with very good mastication. But not be full stomach.

2. Take breakfast as normal on consultation date. But light meals.
3. Do not eat or drink anything from the midnight prior to your surgery including water, or chewing gum but little cup of water before 8:00AM is acceptation.
4. Do not wear any make up.
5. Wear clothes that are loose and comfortable. A button down shirt, flat shoes and loose pants are recommended.
6. If you wear glasses, contact lens or dentures, bring a case with you.
7. Take shower and wash your hair the night before or the morning of your surgery. Do not apply hair gel, hair spray.
8. Do not smoke at least 2 weeks, if you can. This may interfere with healing.
9. Stop multiple vitamins at least two days before surgery.
10. Stop Aspirin two weeks before surgery.
11. The prescriptions you were given are for after surgery. Have them filled ahead of time. If you didn’t get, we will be given to you prior to discharge from hospital.
12. Pre-admission testing (Labs) will be required before surgery.
13. Stop hormone, if taking 14 days before surgery date and able to continue 7 days after surgery date.
14. Bring Cloth napkins (Certainty bed pads). You might need to be use on hotel bed
15. Bring passport to clinic on consultation date.
16. Surgery fee can be pay by cash (AUD, USD, JPY, EURO, CNY, THB, SGD, GBP, HKD and NZD). Please kindly prepare newest version bill and possible without scratch over bill.
17. If pay surgery fee by VISA or Master Card. An extra charge is 3%.
18. Plan to be in Bangkok at least 18 days after surgery date. Totals 23 day in Bangkok.

Things should bring from home for Primary Sigmoid Colon (MtF surgery)

• Button-up shirts in large sizes
• Skirts (not too tight)
• joggers or loose pants
• Slip-on shoes or slippers
• Phone charger, long phone charger
• Books, magazines
• Travel neck pillow
• Personal medicines / HRT
• Regular sanitary napkins, if prefer specific brand
• Underpads

Primary Sigmoid Colon Male to Female surgery timeline periods by Preecha Aesthetic Institute (PAI)

Transportation services will be accompanied by PAI. But must be within 2 KM from Preecha Aesthetic Institute.

Day 0 - Pick up from airport and check in hotel.

Day 1 - Direct consultation at Preecha Aesthetic Institute.

Day 2 - Prepare for Laboratory Testing, Medical health check up and drink liquid laxative bowel clearance

Day 3 - In hotel for good rest

Day 4 - Check out hotel 

Day 4 - Surgery date move to hospital private room

Day 10 - Discharge from hospital after doctor visits
Day 10 to 22 - Check in hotel for recovery period and follow up on doctor appointments at Preecha Aesthetic Institute

Day 22 - Final checkup and prepare for letter fit to fly

Day 23 - Safe to fly and PAI’s escort to airport

Operation procedure Sex change Sigmoid Colon + Penile Skin Inversion by Preecha Aesthetic Institute Thailand - vaginal cavity is create between urinary tract (above) and rectum (below), Bilateral orchidectomy remove, glan penis neuro vascular flap, clitoral reconstruction, urinary tract, labia reconstruction from penile skin + skin flap, lower transverse abdominal incision, sigmoid colon mobilize + segment with vascular pedicle, sigmoid colon segment with double layer suture, colon anastomosis dose with double layer, pull down proximal end sigmoid colon through pelvic cavity+neovaginal cavity, promimal end sigmoid colon skin perineum, abdominal cavity, pelvic cavity, neovergina and abdominal wall closed layers.

A portion of the glans (head of the penis), with its nerves and vessels, is converted into
a clitoris. In so do, the clitoris will be functional in sensation as well as in appearance.

All consultation, medical health checks, preparation and follow up are appoints within Preecha Aesthetic Institute.

Primary Sigmoid colon is performed under general anesthesia (required six days in hospital).

Surgery time required: 5 hours +.

Anesthesia: General Anesthesia.

Affiliated hospitals : Best JCI - accredited International Hospital 

Recovery Sex Reassignment Surgery : Primary Sigmoid Colon + Penile Skin Inversion is required to be in Bangkok at least 18 days after surgery and 23 days all together.

Back to work : after 23 days +. 

Strenuous activity : 6 - 8 weeks.

Fading of scars : several months to a year.

Pioneer Sex Reassignment Surgery

The first multidisciplinary plastic surgery center Thailand.

Preecha Aesthetic Institute

Sigmoid Dilator by PAI

• Range from 25 mm, 28 mm, 32 mm and 36 mm
• Lengths from 15.3 cm (6 inches and up by 0.5 inch)
• Special designed for women following GRS specially by Sigmoid Colon

After sex reassignment surgery sigmoid colon, you are required to be in hospital 6 days and conditions will check by your doctor daily and nurses.

After surgery, pain that is easily controlled by medication usually will subside in a few days. Dressings have been applied; we will be replaced a few days. Sutures will be removed within a week of surgery.

Although the surgeon has made every effort to keep scars as inconspicuous as possible. They are the inevitable result of surgery. Minimal swelling and discoloration will disappear rapidly. Although the surgeon has made every effort to keep scars as inconspicuous as possible, they are the inevitable result of surgery. Minimal swelling and discoloration of the breasts will disappear rapidly.

Healing process may occur for weeks or even months following surgery.  Dilator set will be given an instruction during follow up visits in clinic (the patient is instructed to use dilator until follow visit by appointment at Preecha Aesthetic Institute).

The decision on when to return to work and normal activities depends on how fast you heal and how you feel. You should avoid over activity and refrain from overhead lifting three months after surgery date to permit proper healing.

Treatment after sex reassignment surgery by sigmoid colon technique.

More instructions will be given after surgery.

After release from hospital, you will recover with the aid of liaison at the hotel.

You must follow instructions during recovery in the hotel including:

A. Dilating is the most important thing you can do to ensure the success of your surgery. If you do not dilate responsibly. Failure to continue dilation newly made vagina may cause of the scar contracture.

B. You will be instructed to gently dilate into the right direction after the vaginal packing is removed.

C. Dilation can be painful for the first week, but is essential for developing maximum
depth and ensuring post operative functioning of the neovagina.

Post operation recovery primary sigmoid colon surgery for genital reconstruction surgery

After release 6 days from hospital you will recover with the aid of liaison at the hotel. While recovery in the hotel, you must follow instructions including:

1. Dilating is the most important thing you can do to ensure the success of your surgery. If you do not dilate responsibly, this can result in the shortening of depth and width of the newly made vagina because of the scar contracture. The patient is instructed to use dilator by doctor until follow visit appointment at clinic.
2. Failure to dilate properly can result in serious injury. You will be instructed to gently dilate into the right direction after the vaginal packing is removed.
3. Dilation can be painful for the first weeks, but is essential for developing maximum
4. Depth and ensuring post-operative function of the neovagina. 
5. More instructions will be given after surgery.

During the recovery period and after each dilation session:

• The wound should be washed gently with Hibiscrub (pink color) in the shower followed by douching while seated in the toilet:
• Douche solution (proportion) = 5-10 ml (cc) of Beta dine solution mixed with 1L of water or until the container is full.
• Insert the douche to full depth, squeeze, and hold tightly the container.
• While holding tightly the container, extract the douche;
• Keep the wound dry and apply Betadine solution with cotton balls; and apply Kemicitine ointment with a cotton applicator. If there is some bleeding, press or apply pressure with a dry cotton ball to the site for 15 minutes. During the first weeks after surgery, feminine knapkins (standard) should be changed several times per day due to normal vaginal bleeding during recovery.
• After one month of SRS operation you will be required to start applying Premarin cream to your neo-vagina. Apply two times a day to soften your neo-vagina. This would generally take around six months.
•  Female hormones estrogen can resume after a week surgery. You should consult your endocrinologist to re-adjust the dosage. A sudden change in hormone levels for some individuals may result in the fluctuation of emotion.
• Post - operative checks by the doctor and nurses on a daily basis throughout your stay in hospital.
• Post - operative check-ups by the doctor is by appointments at Preecha Aesthetic Institute or at least twice a week and more frequently if necessary.

For local’s patient - You may resume to work after eighteen days surgery but must avoid heavy lifting object over the head or fast movement during 8 to 12 weeks after surgery date.

For international patient - Please plan to be in Bangkok at least 23 days all together. Stitches will remove day 7 to day 10 after surgery date with remaining dissolve stitches.

After departure from Thailand, you may resume to work within a few days but must avoid heavy lifting object over the head or fast movement during 8 to 12 weeks after surgery date.

◊ Any bruising and swelling will usually dissipate within 4 to 8 months after sex reassignment surgery Sigmoid Colon.

For information only. Please consult your surgeon for medical advice.

Recovery Timeline After Sigmoid Colon Vaginoplasty (Male-to-Female SRS)

Following a Sigmoid Colon vaginoplasty, we recommend waiting at least 4-5 months before engaging in penetrative sexual activity. Healing times vary individually, so always follow your surgeon’s specific guidance.

Weeks 1-2: Hospital Stay and Early Recovery

• Hospitalization: Expect 9 days for close medical supervision, pain management, and wound care.
• Diet: Begin with a liquid diet to allow the bowel to heal, gradually progressing to soft foods.
• Catheter & Vaginal Packing: A urinary catheter remains for 7-10 days. Vaginal packing is usually removed after about a week, at which point dilation and douching begin.
• Mobility: Light walking is encouraged to support bowel function.

Weeks 2: Hotel Recovery

• Dilation: Strict adherence is essential to maintain vaginal depth and prevent stenosis. Frequency and technique will be provided by your surgeon.

Week 3-6: Home Recovery

• Activity Restrictions: Avoid strenuous exercise, heavy lifting, and wide-leg movements to protect incision sites.
• Physical Changes: Swelling, bruising, and some vaginal discharge (bloody or yellowish) are normal and gradually improve.

Months 3-6: Resuming Activity

• Sexual Activity: Penetrative sex is typically allowed after 16 weeks and depending on surgeon clearance.
• Exercise: Gradually return to more strenuous activity while avoiding pain.
• Dilation: Frequency may reduce but should continue to maintain vaginal depth.

6 Months and Beyond: Long-Term Healing

• Final Results: Swelling and bruising resolve; the neo-vagina stabilizes in shape and texture.
• Mucus Production: Sigmoid colon tissue produces natural mucus, which may decrease over time. Panty liners or gentle douching can help manage discharge.
• Sensation: Clitoral sensation may take 6-12 months to fully return as nerves heal.
• Ongoing Care: Long-term dilation and hygiene are essential to maintain a functional vaginal canal.

Following this timeline ensures optimal healing, functional outcomes, and long-term satisfaction after Sigmoid Colon vaginoplasty.

The pioneer Sex Reassignment Surgery and The first multidisciplinary plastic surgery center Thailand - Preecha Aesthetic Institute.