I went to the Mesopotamian clinic and spoke of sacred mé with Dr Enki. His English was middling, but we did spend more than an hour, he wanted very much to explain the history of his method, and was interested in my microbiome research perspective. Of course it was a sales pitch, but together with what I already know, I really do think this is the surgery I should have, for a few reasons.
First, he confirmed what I expected, namely that Thai-style scrotal graft meshworks involve a need to grow new epithelium. This matches very well with the granulation tissues, scar ring contraction, and so forth. The Mesopotamian combined method instead uses urethral, penile and full-thickness scrotal skin to reduce the extent to which the graft/flap combination is stretched. I can very well see this in line with avoiding the hard part of Thai recovery.
Second, dilators are flexible, with a soft tiny placeholder there in between them. I can likewise see how this makes for easier dilations.
Third, the use of urethral tissue really is interesting – it avoids a scar just around the urethral opening when done this way, and may even provide lubrication.
Fourth, he actually showed me statistics of complications and clarified they even work with a Babylon gynaecologist in case they happen.
So this is, in principle, the surgery I should have. To schedule a date they need either proof of insurance coverage or a payment plan. Costs may exceed what I thought, because it’s probably another 10K for the hospital stay itself. So the battle rages on. They’ll send me details of this, and I will try my damnedest to actually get insurance to cover it; otherwise that’s another major cost factor. Which I can deal with probably over the course of the waiting period, if I forgo rebuilding an emergency buffer.
So going now seriously to aim for insurance coverage. And probably looking at a date next fall or so. Nurturing a hope that by that time, circumstances may be right for loved ones to come stay with me and assist me. I believe it will be so.
This does break my fervent desire for SRS recovery done by age 40. But… getting it done safely and well, and without too difficult recovery, may really be more important. I feel I can be (a) patient here.