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Labia Reduction, UK NHS

Labia Reduction, UK NHS

Postby papillion » Thu Jun 14, 2012 6:00 pm

Hi all,
I've just had my left labia reduced (labial trimming, as they call it) on the NHS in England. I thought I'd share my story, and if I can, answer any questions. This site helped me a lot in the months leading up to my operation.
This procedure is not routinely available on the NHS in England. It is however, being requested and performed more and more frequently. At around 15 I became aware of the physical discomfort that came with having enlarged labia, and also experienced the psychological distress associated with this particular problem.
I am now 25. I struggled for years to build up the bravery to tell my GP about my labia, and going for routine check ups at sexual health clinics or at my doctors was always traumatic. So was starting new relationships - the mere thought of having someone touch me down there and imagining their reaction was enough to send me running in the opposite direction. Or worse, I'd get drunk so that I didn't care as much and would end up putting myself in risky and stupid situations.
My GP was unsympathetic. I go to a practice with lots of doctors, and after being told by one female doctor that I was 'within normal ranges' I felt too upset to go again. It began to affect my relationship, as I no longer felt confident to let him perform certain things on me, because I felt so self-concious. A few months later, I went to another doctor at the same practice who, after seeing me in floods of tears, referred me to the practice nurse, who referred me to the gynaecologist at my local hospital.
So you can see, already there are a lot of barriers put up to getting this procedure done on the NHS. If someone less determined or with more shyness had been in this situation, I think they would have given up then and there.
I shall post more in the next section.
papillion
 
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Re: Labia Reduction, UK NHS

Postby papillion » Thu Jun 14, 2012 6:16 pm

OK
So, I had been referred to the gynaecologist at my hospital. You wait a long time for an appointment on the NHS. But I felt there was at last light at the end of the tunnel. My GP was like a gate-keeper, and if I could get past them, then I could plead my case to the doctors at the hospital and hopefully get some help.

My appointment did not go well. I was seen by a young female doctor. She had a look and said that labia reduction and surgery was not available on the NHS and that I should wash with aqueous cream to deal with any chafing I may experience. I began to cry - I knew that this wasn't the case, I had read in medical journals and on internet forums, even on the NHS Choices website that it was given in certain circumstances. She fetched her superior who looked at my labia as well and declared me 'within normal ranges'. I went home and cried in the shower. It sounds stupid but I had really pinned all my hopes on this appointment going in my favour. I had broken up with my long-term partner and was terrified of starting any kind of new physical relationship because of their possible reaction. Not only this, but I had started exercising and found that cycling and running were intensely painful due to my labia rubbing on my clothes. I felt lost. Because I was so embarrassed about it, there was no one who I could talk to, so I kept the feelings of sadness and shame inside.
Eventually, I went back to my doctors for another reason. After a few minutes, I broke down in tears and told him the story. He suggested that I write an open letter to the gynaecology department asking them to review their decision. This was my chance to make them listen to me, and hopefully swing things in my favour.
papillion
 
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Re: Labia Reduction, UK NHS

Postby papillion » Thu Jun 14, 2012 6:33 pm

Heres the gist of my letter, for any of you that may want to give your GP/Gynae some concrete evidence. In 2010, over 2,000 labia reductions were carried out on the NHS (british journal of obstetricians and gynaecologists, 2011).

Current practice is to offer labia reductions to women with labial width of 5cm or greater, or with a difference of 3cm or greater (British medical journal, 2007). However, no large studies on the legnth of womens labia have been carried out so a 'normal range' cannot be defined.

NICE (national institute for clinical excellence) have recently published guidelines stating that every pregnant woman should be offered the option of a caeserian birth if she finds the idea of a natural birth too traumatic or is psychologically distressed by the pain of natural birth. If a woman is offered this invasive procedure even though it is not deemed medically essential, then surely a labial reduction can be performed in order to alleviate the physical pain of exercise, certain clothing, sexual intercourse, and of course the psychological trauma and distress that it causes?

The female genital mutilation act (2003) defines mutilation as the removal or alteration of the external female genital organs for cultural or non-therapeutic reasons. However, the exception to the rule is if the procedure takes place in order to maintain or improve the womans physical or mental health.

I hope that helps - and makes sense. I used all of these reasons (and provided references, so if you use them, look up the original articles, please!!) and guess what - I got re-referred to the gynaecology department...
papillion
 
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Re: Labia Reduction, UK NHS

Postby papillion » Fri Jun 15, 2012 4:00 am

By now, I was pretty traumatised by the gynae department. I associated it with such bad memories, every time I went there I would get stressed out and tearful.
I was seen by the ANP - Advanced Nurse Practitioner. She asked me about the letter, and I repeated what I had told the other doctors. She had a look at my labia, and after a moment she said in a calm voice;

"I think we can do something about this."

I couldn't believe it! I lay there with tears in my eyes and asked her to repeat herself. She smiled, and the chaperone in the room with her was crying as well. I was so happy.

My operation date was set for the 16 May 2012, but then got moved to 13 June 2012.
papillion
 
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Re: Labia Reduction, UK NHS

Postby papillion » Fri Jun 15, 2012 4:07 pm

So, my op date finally came around. Strangely, I wasn't nervous at all. I just felt happy. My life as a woman who is confident in her body is about to begin after all this time!I stood in front of the mirror and took a mental note - "this is the last time you will look like this" I said to myself.

I hadn't eaten or drunk anything since about 10pm the night before the operation. I was due to go under general anasthetic, and had to be at the hospital at 11.30 am on Wednesday 13 June 2012. I packed my slippers, dressing gown, a couple of magazines, a book (and my kitting, haha) because I know how long it can take sometimes, especially when surgery waiting lists are involved. I also packed my toothbrush and deoderant - just in case I had to stay overnight.

When I got to the hospital I was shown to a shared bay with other ladies. They were all there for different things and were in different stages of their journey - some just coming round from anasthetic, some still waiting to go down to theatre. I sat in my chair and answered all the nurses questions as she admitted me, such as whether I had any fillings, jewelry etc. I also gave a urine sample.

Then, after about two hours, I was seen by the anesthetist who filled in some more paperwork. I was given one of those cool wrist bands with my name and date of birth on, and asked to change into a hospital gown. I was then escorted on foot down to theatre.

In the bay, another anethetist checked my details again and got me to sign another form stating I understood what was going to happen. Everyone was so friendly, although I was beginning to get nervous they made me feel at ease.

A cannula was inserted into my hand to allow the anesthetist access to my veins, and then I got onto a narrow bed and was wheeled into the anasthetic bay.
papillion
 
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Re: Labia Reduction, UK NHS

Postby papillion » Fri Jun 15, 2012 4:17 pm

Once in the anasthetic bay, I was welcomed by three people, two anesthetists and a nurse. They made me comfortable lying down on the bed and hooked me up to a heart rate monitor, which also measured my blood pressure, oxygen saturation and heart rhythm. I was given an oxygen mask to wear, and they administered a relaxant into my cannula.
"You'll be asleep soon" they said.

I woke up in the recovery bay with a friendly nurse sitting by my side, taking my blood pressure. I immediately began to cry - I realised straight away that it had finally happened, the thing I had been wanting for 10 years! The nurses rushed round and comforted me, but I couldn't explain to them why I was crying. I said it was from happiness!

They asked me about the pain. It was there, and I was uncomfortable, but it wasn't unbearable. They asked me if I needed pain relief...and I said yes please! Give me some of that good stuff. The nurses were not stingy with the old morphine.

My pulse was very low. Too low - at times it was only 38 bpm (a healthy resting rate is between 60-80). I was in the recovery bay for about 45 minutes before they took me back to the ward. Unfortunately, this was only the start of the drama.
papillion
 
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Re: Labia Reduction, UK NHS

Postby papillion » Fri Jun 15, 2012 4:40 pm

Whilst in the recovery bay I was bleeding quite a lot, but after about an hour it slowed down and the nurse in charge let me have some toast and a cup of tea. It was delicious.

After another half hour she came back to check on me. I told her I felt a bit damp, and that I needed to go to the toilet as well. When she came back with the bedpan she checked my pad - and almost fainted! I had bled everywhere, it looked like a scene from the exorcist.

She let me go to the toilet and then gently cleaned me up and changed the bedsheets and my night gown. She put a fresh pad on me and said she'd be back to check on me soon. Unfortunately, when she did the same had happened again, but worse. She took a closer look and saw that I was actively bleeding from the stitches they had put in during theatre. Obviously they hadn't put enough in, or hadn't done them tight enough.

By this time I had been out of surgery for about 4 hours and had been bleeding consistently for about 3. I was starting to feel very light headed and tired, and my already weak pulse that had only just gotten above 50 was falling again. The nurse called in the doctor and I was rushed back to theatre, still bleeding.

Because I had eaten, the nurse in the anasthetic bay had to put pressure on my throat to stop the contents of my stomach coming up into my aesophogus and going into my lungs to choke me. They had to use more anasthetic to get me off, and the last thing I remember was the oxygen mask being over my mouth and them telling me to keep my eyes open and breathe as deeply as I could. I did as I was told, and said before I KO'd "I'm going, guys!"
papillion
 
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Re: Labia Reduction, UK NHS

Postby papillion » Fri Jun 15, 2012 4:53 pm

This time when I came round, I was in a lot of pain. I made the nurses in the recovery bay give me as much morphine as they were allowed to. In fact I got so much that my respiration rate went down to 4 breaths a minute (an average is between 8-12 if you're at rest). By this time it was about half 10 at night. It's a good job I packed my toothbrush.

I stayed in the recovery bay, with my stupid low pulse, for about an hour. They then transferred me to the surgical gynaecology ward where I was wheeled into a private cubicle and left to sleep.

The nurses came in frequently to perform my physical observations - every half hour for two hours, then every hour for two hours, then every two, then four hours. I don't remember a great deal of this time - I was so sleepy and disorentated. In fact, when one doctor came in to speak to me, I actually fell asleep mid-conversation!

The next day, I spent most of it asleep. I had been catheterised whilst in surgery, thankfully this meant that I didn't have to get up to urinate. I just lay in bed all day, sleeping. I wasn't able to do anything else.

When I finally got up to look in the mirror, I looked like something from a zombie film! I had huge dark circles under my eyes and my lips were chalky white. I looked such a mess.

The doctor came and took a blood sample - I had almost needed a transfusion in the night and said that my HB (haemoglobin = blood) count was low after losing so much so I would be prescribed iron tablets. She was also prescribing antibiotics as I had been in surgery twice in one day. I was given oramorph (oral morphine) whilst in hospital and ibruprophen, paracetamol and codiene to take home for the pain.
papillion
 
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Re: Labia Reduction, UK NHS

Postby papillion » Fri Jun 15, 2012 5:13 pm

If you guys want to ask me anything please feel free, I was going to put pics up but I don't know how to do it on this site, sorry.

Best wishes
Papillion xoxo
papillion
 
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Re: Labia Reduction, UK NHS

Postby papillion » Wed Jun 20, 2012 3:55 pm

Hi guys,

Just thought I'd check back. It's one week since my operation. The bruising has almost gone now, although the area between the stitches is still pretty swollen. Thats the most uncomfortable part - its not itchy or sore, but I think the surgeon must have put really tight sutures in to make sure I didn't start bleeding again.
I can't wait for them to dissolve. Its like a pinching sensation all the time, and very uncomfortable. One of the sutures did come undone today though, and I gently removed it (it slid out easily) as it was catching on my underwear. I am still taking my antibiotics and painkillers as well, and if I'm late for a dose I really notice the tenderness.
Visually, I think you can tell this is an 'NHS Job'. Unfortunately, I didn't get to see what it looked like the first time round as I was taken back to theatre to get re-stitched, but from what I can tell it's not the...neatest finish. Perhaps it will look better when all the swelling has gone down. Also, at the top my laibia still proturudes slightly from my outer lips. But I keep telling myself that its 100 times better than it was, and that's what matters.
So, I guess I'll update this in another week and let you know how I'm getting on! :)
papillion
 
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Re: Labia Reduction, UK NHS

Postby eatsrainbows1 » Sun Aug 11, 2013 4:44 am

This story is quite breath taking. The GP's in my local doctors i have no trust with whatsoever due to previous mistakes they have made. (telling my dad its impossible to get rid of diabeties and that he was going crazy when he told them, hed just had half his pancreas replaced!). You were exactly the same as i am now and its got to the point where its gettng too much. did you tell anybody that you were going in for the surgury or did you go in solo? because if it was solo i respect you a great deal! Gps need to have more empathy towards people who have just started crying in their office eh?
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Re: Labia Reduction, UK NHS

Postby izuminka91 » Wed Sep 04, 2013 6:12 am

Hey guys. I have the same porblem and my question. I am 22 years of age and my question can I still have labioplastacy on NHS. I have contacted my doctor, he said that what I have is a problem and he made an appointment to gynecologist for me.
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