XVII Harry Benjamin International Gender Dysphoria Association Symposium
31 October - 4 November 2001, Galveston, Texas, U.S.A.

Improving the Best Practices Approaches to Post-surgical Dilation

SUMMERS, JUDY ELSPETH U.S.A.
Co-author: Anni Z. Li (U.S.A.)
E-mail: info@stentsitive.com

This paper suggests additional measures to improve physician-patient communication and develop best practice approaches for post-surgical care in the area of male to female gender reassignment surgery. Such practices emphasize normative communication methods that ensure improved and consistent patient self-treatment during the post-surgical recovery period. The specific content here emphasizes the regime of post-operative care practices for dilation following gender reassignment surgery involving the construction of a neovagina. Dilation in this context refers to neovaginal tissue expansion: the process whereby tissue is expanded by means of stents or dilators used as tissue expanders. Instruction in dilating practices during immediate post-operative care has been less than consistent as revealed by the minimal literature available. The most acute and symptomatic example is the general lack of follow-up due to patient reluctance to reveal their medical history as well as the inattention of the medical and research community in developing historical studies of the post-operative community. Enhanced communication between the professional community of caregivers and their patients improves adherence to treatment recommendations. Such improved patient compliance and readiness will reduce the potential problems of post-operative physical and psychological harm due to improper or inadequate dilation. Providing more consistent post-operative dilating information as best practices supplements the Standards of Care by reinforcing compliance with recommended aftercare treatments. Three improvement areas are emphasized: aftercare information, dilation training, and the optimal design of effective vaginal dilators. These measures provide a cost-effective way of increasing compliance and improving the overall health of patients. Training documents such as "Zen and the Art of Postoperative Maintenance" and its website URL are designed to instruct patients in information seeking, provision, and verification. The perception of improved and consistent practices helps patients make better decisions in their choice of surgeon as well as increasing the chances for a satisfactory surgical result. The mutual information discourse related to post-operative care positively influences compliance with behavioral treatments and follow-up appointments and referrals.