Primary Colon Segment Vaginoplasty
with Dr. Pichet

By Leslie

I traveled to Bangkok, Thailand in May 2003 to undergo SRS with Dr. Pichet Rodcharoen. Although my partner had significant reservations about such major surgery in Asia, I had done sufficient Internet research and personal referral validations, to feel confident in my selection of Dr. Pichet to perform my SRS.

The plane trip from the US was long and tiring, but uneventful. We arrived in Bangkok at 11:00 PM and quickly made it through Thailand customs. Dr. Pichet had arranged a limousine to pick us up at the airport. The driver took us to our hotel about 30 minutes away. As we checked in, the hotel gave me a message from Dr. Pichet advising us that he would send a driver to pick us up the next morning. The hotel was a nice ďbusiness class hotel, at a rate much lower than equivalent accommodations in the US.

A driver arrived to take us to Dr. Pichet's clinic at 9:30 AM. It was about 10 minutes away. As the driver pulled up to the clinic, both of us felt very uneasy. Rather than an office in a modern medical complex, Dr. Pichet's clinic is a storefront in what appeared to be a very "locals only" part of town. Street vendors and markets surrounded his clinic. Somewhat concerned, we ventured in and were greeted by one of his associates. The facility was clean and much larger than it appeared from the outside. We were escorted upstairs to an office and asked to fill out basic paperwork. His staff was very friendly and offered tea and conversation while we waited for the Doctor.

When Dr. Pichet arrived, we briefly discussed what I wanted and he then did a quick physical examination in an adjacent room. We reviewed the various procedure alternatives and I felt that a primary sigmoid colon vaginoplasty was the best alternative. Dr. Pichet carefully explained the possible risks and made sure that both my partner and I fully understood. Dr. Pichet seems to feel that this is the best procedure, but is very hesitant to strongly recommend it, since it does carry higher risks. He has not had a patient that experienced significant complications with this procedure. He says that he is "lucky," but I feel that it is his skill and attention to detail that contributes to his record of successes. I ask him to schedule the surgery as soon as possible, so after phone calls to the hospital and the associated general surgeon, he reported that it was set for 8:00AM the next morning.

Once the decision was made, we completed additional paperwork and paid his fee. Dr. Pichet does not require a SRS referral letter, but if you do not have one, you must write a personal history essay for psychiatric review, explaining your motivations for SRS. I had a letter, so this was not an issue for me. Dr. Pichetís staff took us directly to the hospital for pre-admission tests. His assistant handled all logistics, paperwork and communication with the hospital staff.

Following the various tests, I was admitted and placed in a large private room. The hospital had the look and feel of a large urban hospital in the US. Dr. Pichet's staff made sure that I was all settled and then took my partner back to the hotel to get various clothes and toiletries. They escorted her back to the hospital in a couple of hours. Dr. Pichet's staff was always available and made both of us feel as family. I have never experienced this level of care and compassion from a US doctor.

That night, they prepped me for surgery and required me to drink 6 large bottles of fluid to cleanse my digestive track. There apparently were some anomalies with my EKG, because a cardiologist came and examined me before Dr. Pichet gave the green light for surgery.

The next morning, Monday, they took me to the OR. I was conscious and talking with the doctors as they strapped me to the table. The surgery took six hours with no complications. I awoke back in the room, with my partner at my side. I slept the remainder of the day. I don't recall any pain.

Tuesday morning I awoke and was aware of most everything around me. The genital surgery area was bandaged, with no pain. The abdominal incision caused moderate pain when I moved. My legs ached and my right foot was numb. Dr. Pichet examined me and said everything looked good. I was in and out of sleep all day. The most discomfort I had was with my legs. A mild fever coupled with poor air conditioning circulation kept it uncomfortably hot in the area of the room near my bed, so Dr. Pichetís staff brought a fan to solve the problems.

By Wednesday, I was feeling better and off pain medications. The hospital arranged for a Thai foot massage for me and a full body Thai massage for my friend. The foot massage significantly improved the numbness in my right foot. I still had limited mobility due to pain from the abdominal incision.

On his morning visit Thursday, Dr. Pichet said that he would release me to go back to the hotel later that afternoon. I was very excited and ready for a softer bed. He sent two staff members and a driver to take us to the hotel. Although my partner stayed with me the entire time I was at the hospital, Dr. Pichet frequently offered to have a staff member relieve her so she could get some rest. He and his staff really seem to care. They brought in lunch to her so she would have alternatives to the hospital food and offered most every service imaginable.

The Hospital staff was very efficient and provided excellent nursing care. There was always at least one nurse on duty fluent in English. Most of the other hospital staff spoke little English. There were several English language TV stations.

Several members of Dr. Pichetís staff came to my hotel room Friday morning. They changed the bandages and said everything looked good. I rested in the hotel all day Friday. I was tired, but had no major discomforts.

Dr. Pichet examined me in the hotel room on Saturday. Satisfied with my progress, he provided transportation for a visit to his office on Sunday. After a complete examination and photos, Dr. Pichet instructed me on dilation technique. I was feeling much stronger and we ventured out shopping and sight seeing that afternoon. Dr. Pichet made his chauffeur and car available to us for a very reasonable fee. This combination of driver, escort and tour guide made seeing Bangkok very safe and pleasurable.

For the next several days, we would shop and sight see following a daily visit to Dr. Pichet's office for a quick exam. I would tire after a few hours, but was ambulatory and able to walk significant distances to enjoy tourist destinations and shopping malls. Evenings were spent watching movies in the hotel room. I went for my final exam on Wednesday morning. Everything was healing well, and Dr. Pichet released me to return home.

It has been one month since surgery and I have had no significant complications. The general appearance of the vagina is good, although there is still some swelling of the labia. I continue to experience minor leg numbness and aching and occasional nerve "shocks" from inside the vagina. Sitting for long periods on hard surfaces is uncomfortable. I have been back at work since the day following my return. I tire easily, but feel that I am doing quite well for only one-month post surgery.

My vaginal depth is about 7 inches. For the first two weeks there was minor daily discharge. At this point, I only seem to have discharge following dilation. The quantity of discharge seems dependent upon the size of dilator and how aggressive I am with it. The discharge is an almost clear mucous with occasional traces of blood.

I am very satisfied with the results. Dr. Pichet and his entire staff treated us like family. They were available to provide any possible assistance, even the loan of a cell phone. I would encourage anyone to seriously consider Dr. Pichet as their SRS surgeon. The level of personal care and attention he offers is unmatched by US doctors.

I would like to extend my personal thanks to Dr. Pichet, Mao, Taew, Lek, Tak, Sao, Ying, Moo, Hai and his entire staff for their exceptional efforts and carre during our stay in Bangkok.

© 2011 by Anne A. Lawrence, M.D., Ph.D. All rights reserved.