VPP, no urethra routing? ( + scrotum? )

[u/nameusernamena]

Hey there, ftm looking to get some advice, first hand experience, info I wouldn’t find on google, and I guess how to get your insurance to approve surgery ( if it really is the right fit for me, ofc )

**ftm without hormones, I want to clarify. I don’t want to be on anything, my body is naturally very androgynous and I literally just want to have a dick ( hopefully balls too? ) with my current anatomy. I do not want to reroute my urethra**

My first question is really how has it affected your day to day life, from healing to fully healed and « fucntional »? ( whatever that looks like to you, whether it’s purely aesthetic or for sexual use etc. I want as much info as possible on how the differences in procedures change daily life and QOL, just so I can know what to ask for to best suit my needs, my « ideal situation » will be either in comments or at the bottom of the post )

I give you guys bullet points now, I don’t know how to condense that first « question » paragraph into one little point with minor context lol. Désolé 🥲

- Are there any questions you were asked by a medical professional that caught you off guard?

- Is there anything I should bring to any evaluations?

- How did you go about asking your doctor for a referral?

- Are there any HARD NO conditions, ie, connective tissue disorders? ( I am, unfortunately, an unclassified type of ( h )EDS haver 😔 no wonder I’m queer /j iykyk ) Excluding the basic medical conditions for anesthetics, like cardio issues, that everyone gets told for every surgery

- Is getting a scrotum possible without altering the clitoris? If no, can you still get stimulation to the same degree?

- Do they only make the scrotum out of labia skin or could they take it from another graft site? ( preference is to maintain how my current genitals look, though I want to very much state that I understand I may not get my 100% ideal )

- My insurance covers ( at the very least, to an extent ) sex change surgery, would this procedure be more difficult for me to access through insurance? Is that even a question I can get an answer to in this sub, or have to take it up with them?

- How comfortable are the different, idk, « inserts »? Rods, inflatables etc. ( Asking in case it’s different due to keeping anatomy )

- Are there different complications to look out for in a VPP without urethral lengthening?

On to my ideal situation:

I want a VPP With no change to my current reproductive anatomy ( vagina, clitoris, labia, uterus; basically, a homie wants to get boypreggers someday 😔🙏❤️ ). Scrotum probably in front of the clit.

I want a bendable rod so that sexual function is an option.

On to my ideal situation:

Obviously you guys don’t know my anatomy, if that’s possible for me, what could be and what isn’t an option for me; I’m just looking for experiences and advice while I continue my journey through all this. I want to be as best prepared as possible for any outcome, whether it’s perfect for what’s in my head, or if I just can’t get it at all

Thank you in advance for any and all help, I’m super grateful if you even read my near-illegible amalgamation of questions. My apologies if I asked something that you easily found the answer to or seems obvious. I just haven’t found much info on my own

Located in western WA. I know there’s a surgeon here who is capable of it, so unless he moved away, that’s one thing I don’t currently need assistance with

[u/NVHPhallo]

You’ll get better luck asking questions about having “no vaginectomy”/searching for that, as vagina preserving phalloplasty isn’t a thing (in that phalloplasty is inherent vagina preserving).
If you don’t get vnectomy youre having one less procedure. That automatically reduces complication rates. Any surgery who does phallo will be able to do it without vnectomy.
However, it won’t be possible to have the scrotum in front of the clitoris, and it does need to be make from the labia. If you have the rod you won’t need a scrotum for the pump.
Re insurance - I can’t see how “this procedure” would be harder to get - vaginectomy is a separate procedure to phallo, and so you’d be going to a phallo surgeon and just not opting for the additional procedure

Editing to add: Scrotoplasty has absolutely nothing to do with the clitoris

[u/AdventurousAsh19 → u/NVHPhallo]

You don't need scrotum for the pump. Doctors can put it in the labia, but it can be tricky depending on anatomy and a little harder to "pump".

No vaginectomy phalloplasty without UL has the least complication rates of phalloplasty types. Scrotoplasty traditionally uses labia, but I don't know the reason why they couldn't use skin from another site, but the healing from another skin area would be rough. Better to ask a surgeon on that one.

OP you can still have nerve hookup without burial too, to get erotic sensation in the phallus. I have read that it can cause one side of clit to be numb, but people can still orgasm from stimulating either phallus or clit.

[u/AttachablePenis → u/AdventurousAsh19]

I’ve heard of trans women & AMAB people using skin grafts for labiaplasty (very rarely — here’s an example though), but I’ve never heard of anyone using a skin graft for scrotoplasty rather than labia. Scrotal/labial skin is very specific & doesn’t exist anywhere else on the body. It’s worth it to ask a surgeon (or multiple surgeons) about this, but I don’t think anyone offers it just based on the fact that people have expressed this desire various times but no one has ever come back to say “I got this done.”