All surgical procedures involve some risks. Risks include negative reactions to anesthesia, blood loss, blood clots and infection. These complications can, in extreme cases, result in death. It’s important to discuss these risks in detail with your surgeon. Your surgical care team will take a wide variety of steps to prevent these problems, detect them if they arise and respond to them appropriately. They will also inform you about what you can do to minimize your risks.

Some complications are particularly associated with phalloplasty. Below are a list of some possible complications of this surgery. Please note – this list is not comprehensive and you should have a detailed discussion of risks with your surgeon.

Abscess formation

An abscess is a collection of pus caused by a bacterial infection. It can be treated with antibiotics or drained by the surgeon.

Decreased sensation or ability to achieve orgasm

There is risk of decreased sensation or inability to achieve orgasm after surgery. 

Dissatisfaction with size or shape

Some people may be dissatisfied with the size or shape of the erectile tissue (penis). You can check with your surgeon to see if surgical revision is possible.

Hematoma

When blood collects in the surgical site, causing pain, swelling and redness. It is the most common complication. Drains and compression bandages are used to prevent hematomas. Smaller hematomas can be sucked out, but larger ones require removal through surgery.

Implant complications

Complications associated with penile implants include poor positioning, technical failure and infection. The implant can be either be repaired or surgically removed and replaced. Complications associated with testicular implants include poor positioning and infection.

Numbness in the hand or wrist of the donor arm

Usually resolves in a few weeks. Permanent changes to sensation or function are very rare but possible. Some people require prolonged physiotherapy to recover.

Wound separation

The partial or complete opening of incisions along the sutures.

Scarring

You can take steps to prevent severe scarring by following your surgeon’s advice about avoiding sun and doing massage exercises. Severe scarring may require surgical revision.

Seroma

When clear fluid accumulates in the surgical site. Small seromas may need to be aspirated, or sucked out, once or more by the surgeon. Big seromas may need to be removed through surgery.

Tissue transfer complications

Related to the transfer of skin from your forearm to your groin. There is a small risk of a partial or complete loss of the penis if the transfer is unsuccessful.

Urological complications

Very common, though they often resolve with time. Examples include fistulas (flow of urine to areas other than urethra opening), stenosis(narrowing of the urethra, causing difficulty urinating), strictures (scarring inside the urethra, causing difficulty urinating) and hair growth inside the urethra. If these problems don’t resolve on their own, they may require additional surgery.