Know what to expect after surgery

Below is a description of what generally happens when you wake up from phalloplasty, metoidioplasty and erectile tissue release surgery. This information is provided to help you start imagining what the hospital experience could be like- you will be given more detailed and up-to-date information once you have your surgical consult and meet your surgical team.

Each surgical centre is different and your surgical team will provide you with more detailed information about what to expect when you wake up from surgery.

In general, here is what you may expect: 

After surgery, you will be moved to the Post Anesthesia Care Unit (PACU). You will feel quite drowsy when you wake up -this is normal. It is also normal to feel sick to your stomach (nauseated) or to throw up after surgery.

Erectile Tissue Release & Metoidioplasty

Some people choose to have erectile tissue release surgery without any additional procedures, while others may choose additional procedures. Information about what to expect for each procedure is below:

Medical equipment

You may have some or all of the following:

  • an oxygen mask
  • an IV line
  • calf compressors to prevent blood clots

Erectile tissue release

You may have bruising and swelling in the groin area (abdomen and thighs).

You will have small incisions on each side of the groin, where the ligaments have been cut.

The erectile tissue will be puffy and swollen. This swelling tends to go away in two-to-four weeks, but could take longer for some.

The tissue may feel tender and uncomfortable while it is healing.

If you did not have urethral lengthening, you will not have a catheter in place. You will be able to urinate as you did before the procedure.

Urethral lengthening

If you had urethral lengthening, you may also have a catheter that starts in your bladder and comes out the tip of your penis to help keep your urethra open- this is called a urethral catheter. You may also have a catheter that starts in the bladder and comes out of your lower abdomen, near the pubic bone- this is called a supra pubic catheter.

Your surgical team will let you know when you can start urinating through your new urethra – this generally happens between 1-3 weeks after surgery.

Experiences of having a catheter can vary. For some people, the catheter may be very uncomfortable. It is important to speak with your surgical team if you have any challenges with your catheter.

While you have your catheter, it is very important to drink enough water to make your urine a pale yellow colour.

Scrotoplasty

It is common to have bruising and swelling in the groin area (abdomen and thighs).

You will have several incisions on the scrotum, including along each side and at the mid-line. It is normal for there to be some dried blood and clearish fluid present at the incisions.

You may also have 1-2 drains at the scrotum to help extra fluid leave your body.

If you are getting testicular implants, this procedure tends to take place around six months after your first surgery.

Vaginectomy

You will have an incision at the site of your vaginectomy. These incisions may feel ‘tight’.

You may experience a sense of aching where the internal tissue was removed.

It is normal for there to be some dried blood and clearish fluid present at the incisions.

Other details

Members of your surgical and post-operative team will check on you frequently.

You may be given some breathing, leg, ankle and arm exercises to do throughout the day. You may feel emotional and very tired- these are normal responses to having a big surgery and if you follow your surgeon’s post-operative instructions, your body will recuperate with time.

Phalloplasty

Medical equipment

You may have some or all of the following:

  • an oxygen mask
  • an IV line
  • calf compressors to prevent blood clots

Bruising

It is normal to have bruising in the groin area (abdomen and thighs)

Penis

Your penis will be swollen. It may be supported in a sling to reduce swelling. It will feel numb.

You will have incisions at the point where your penis connects to your body, and along the underside of the shaft. You will also have some incisions on your scrotum and at the vaginectomy site.

You may have a drain in your groin to help fluid drain from your body.

There may be a small device called an “implanted doppler ultrasound” embedded into the skin of your penis to measure blood flow to the area.

If you had urethral lengthening, you may also have a catheter that starts in your bladder and comes out the tip of your penis to help keep your urethra open- this is called a urethral catheter. You may also have a catheter that starts in the bladder and comes out of your lower abdomen, near the pubic bone- this is called a supra pubic catheter.

Penile donor site

Your penile donor site may have a special dressing called a vacuum assisted closure (VAC)  to your penile donor site, which is connected by a drainage tube to a small, portable vacuum pump.

Skin graft donor site

This area can be quite sensitive or painful, as the nerve endings here are exposed to the air as you heal. It may have some drainage and be covered by a bandage.

Other details

  • Members of your surgical and post-operative team will check on you frequently.
  • You will be on bed rest and nurses will help you with all your care needs.
  • You may be given some breathing, ankle and arm exercises to do throughout the day.
  • You may feel emotional and very tired- these are normal responses to having a big surgery and if you follow your surgeon’s post-operative instructions, your body will recuperate with time.