Nullification experience in Essen
Hello all! I thought I'd make this post, since I cannot find any other relevant accounts about Uniklinikum Essen, and then I might as well connect it with the subjective experience I had post-op.
Back in 2024 I asked around and heard that the Uniklinik Essen offers a nullification procedure, and they perform multiple annually. I received a pre-speak appointment with Dr. von Ostau late that year - my operating surgeon, Prof. Dr. Heß only had open slots for pre-speak appointments years down the line, while Dr. von Ostau had one available in relatively short order. She was extremely kind and professional, spoke English, answered all questions, drew up the diagrams (they had no pre-made handouts for this), looked at my references. She was also extremely open to any kind of gender expression, I could have chosen any kind of post-op HRT and also any kind of a combined top surgery, additive or subtractive. They perform about 9 nullifications a year iirc, and take special care to minimize scarring. The only point of friction was their policy of halting HRT before surgery.
The wait time for the surgery was partially my doing - I still had to get my paperwork in order. Mine was out of pocket (they would have taken a German insurance indication), but I still needed local insurance in case I ended up in the ER, as well as one psychological referral. Regardless, their administration had been rather glacial - lots of mailing back and forth and phone calls to urge them forward to process my papers, send me the cost projections, accept my signature, and get my scheduled, which eventually happened this spring. It may be faster for those not going through foreign patient service, I don't know. In the mail I was only instructed to stop some very specific medications, blood thinners, and to take out all piercings and remove all nail polish.
The day before the surgery admittance was extremely slow with barely any communication or waiting room accommodations. The clinic also mixes urological and SRS patients, so it's a few young women waiting among mostly older men. Multiple hours after the time I have been told show up for, I was finally admitted by a doctor. Her field was not in SRS and my file only said "penectomy", so I actually had to fetch my papers and diagrams and explain what I was getting, which stressed me out since I had no way of knowing what they were going to do as an operation, since they clearly had no template for this, and I was ordering off the secret menu. She rattled off the risks, some of which were irrelevant due to this not being a vaginoplasty. I also received a frown when I confirmed I did not halt HRT, but it ultimately did not prove to be a problem, they are somewhat flexible about this. The entire time I was getting by with my middling German, and I did not test the extent of their knowledge of other languages.
Once I received my room, I was approached by one surgeon, then Prof. Heß himself for a precious minute or two during which they asked me what sort of a clitoris arrangement I wanted. I took care to quickly explain everything and show reference pictures, but it too was a last minute correction which again, stressed me out. At least I can confirm that they are flexible about how they do the nerve-preservation and aesthetics, they will do an exposed glans if one wishes.
Surgical prep was uneventful, I took care to fast well in advance. The crew, all the nurses, the anesthesiology team, everyone was extremely lovely and in a good mood, and naturally they checked what I was getting more than once. Waking up was very unpleasant - I had an opiate pump (very nice to be able to control when I needed a dose) which I was using on cooldown, but the pains eventually subsided, especially once my catheter was adjusted. The only really painful part was whenever I reflexively clenched, which was also mostly the moment the wounds drained. Being past the surgery did wonders to my anxiety though, especially between the mix of sensations and the little peek under the top of the compression dressing.
The room I got was extremely nice and well-equipped, and probably a women's room (which I was clocked as, to my preference). I didn't pay for extra accommodations, but it was a clean, bright, and well-decorated two-person room with a good bed and a large bathroom. I could not keep down any food due to nausea for a while, and I was on a liquid diet for the day of the surgery and the day after. The food was quite okay and tastefully presented. Vegetarian options were quite passable, vegan options were limited (but sometimes present), though I did receive completely random food for a day or two before they could ask my preferences, despite noting them down in the admission paperwork. I also did not receive my listed medications for the first day or two, and when I did it was poorly communicated what the nondescript pills were. The nurses were very kind, attentive, and consistently in a good mood, also there was a reassuring number of them on the floor. Any visiting doctors were also kind and polite, but they did not have much time at any point.
After a couple of days I lost the most annoying cannula, was off opiates and eating solid food (possibly the most delicious food in my entire life), and everything was quite uneventful. I was encouraged to stand up, which I did, though it was quite inconvenient due to all of the tubes. The compression dressing and drainage came off three days after the surgery, which was a huge improvement in comfort, and I got to finally take a look. Afterwards it was far easier to walk around, too. Being unwashed for that long was quite disgusting, but I got a sponge bath on request. Visitors were not a problem at all.
I was released on day five once my catheter was pulled. By that point I could walk (slowly and badly), and was feeling more than well enough to feel like leaving. I had a bit of walking an train ride ahead of me, which was daunting but also manageable thanks to the donut pillow and taking it slow. Postop care info was only written down on my request, a 14 day abstinence from the usual, such as hard physical activity and bathing.
Overall the experience was pleasant, but organization was consistently on the chaotic side with many delays aside from the actual surgery.
As for the results: I am extremely satisfied. The scar is minimal and the entire thing is very aesthetic, also according to others who have underwent the surgery elsewhere. The urethra is placed well, though I still have excess swelling that makes it messy to use. It is somewhat different to what I usually see here, more of a divot or a slit than a strictly defined hole, but I like it that way.
With simply lying about and using some cold packs, I was reasonably comfortable during the first week home. A week after the surgery I could manage a pleasant walk around the area, within two weeks quite a bit more and with more vigor. It was also at the two week mark when I first tested the function of the nerve-preserving part (it works). The root stiffens, but does not get unpleasantly or visibly erect.
At the three week mark I had close to full function aside from heavy physical tasks. I could go places and cook meals. At four weeks I had my checkup back in Essen - once again it was a couple hours after my actual appointment date, but everything was declared fine, and the swelling should further subside in the coming months.
I hope this helps anyone considering the Uniklinik and Prof. Heß! I can recommend it, as long as one can stomach German bureaucracy. I'm quite happy and excited to go on with my life that much more comfortable. Feel free to ask anything!
tl;dr: the organization is a mess. the surgery is very good. healing was fast. I am very satisfied with the results, and the stay was made pleasant by the environment and the good attitude of the staff.