Mindfully return to usual activities

Ask your surgeon when you can resume your usual activities. The information below are some common post-operative recommendations and does not replace the information you receive from your surgeon. If there are any difference, you should follow your surgeon’s instructions.

Driving

Avoid driving until you are no longer taking any opiate pain medication or feeling distracted by pain. Only drive if you are able to:

  • Put pressure on the break quickly and without pain
  • Safely do a shoulder check
  • Wear your seat belt

Start with short trips so as not to put too much pressure on your genitals. If you drive long distances, take frequent stops & pee often.

Lifting, Pulling and Pushing

Avoid lifting objects over ten pounds until 4 to 6 weeks after surgery, including carrying children, pets and groceries.

Work

Plan to take at least 6-8 weeks off work, or longer, depending on type of work and how you are healing.

Exercise

A general rule is to wait until 6-8 weeks after your surgery before participating in intense physical activity. Speak with your surgeon about how you can restart any activity, including exercise.

Rest

Rest is important for your recovery. Your body does its healing while you rest. Take naps or rest breaks during the day.

Sexual Activity

Lots of people have questions about returning to sexual activity after surgery. This can include, but is not limited to, masturbation and sex with other people. As with all other activities, speak with your surgeon about when it is safe for you to be sexually active after surgery.

Exploring how your body feels and responds after surgery is an important step in your healing process. It stimulates the nerve endings, helping them heal and reconnect, and allows you to begin the process of finding where and how you enjoy being touched. It also helps your brain to create a new “map” of your body.

First 10 days after surgery

First 10 days after surgery:

Avoid activities that can lead to elevated blood pressure and the risk of internal bleeding (hematoma).

This includes:

  • Having any kind of sex (alone or with a partner)
  • Having an orgasm
  • Other activities that create risks for bleeding, increase the risk of discomfort or pain or that may disrupt your anatomy while it heals

8 weeks after surgery

  • Your genitals will be numb at this time and your incisions are still vulnerable. It is important to follow all the post-operative instructions and be very gentle with your penis.
  • Do not place anything inside your genitals or rectum beyond what has been recommended by your surgeon(s).
  • Workbook for Phalloplasty, Metoidioplasty and Erectile Tissue Release Surgery in BC for some suggested mindfulness activities.

12 weeks after surgery

12 weeks after surgery:

If you have had metoidioplasty or erectile tissue release surgery, your surgeons will give you customized information about when it is safe to start using a pump for getting erections.

Once your surgical team tells you that you’re ready to use your genitals for sexual activity, here is some general information for returning to sexual activity after surgery:

  • Follow your surgeons’ recommendations regarding return to sexual and other physical activities.
  • Take time to learn your body’s needs and preferences.
  • Ease back into your sexual activities.
  • You may find your sex drive is different from before surgery. It might be lower during your healing period or you might find it’s higher.
  • Everyone is different. It’s important to know that changes to your sex drive are a normal part of your healing journey and will balance out over time.
  • Do not place anything inside your genitals or rectum other than what has been recommended by your surgeon(s).
  • You may find that your endurance or tolerance for different activities and sensations is affected by your surgery or pain medications.
  • Stop or take a break if you feel pain, or you feel anxious or scared.
  • Pay attention to whether your swelling or tenderness increases after sex. If so, you may want to wait until you are a bit further along in your healing before having sex again.
  • Pee before and after sexual activity to reduce the chances of urinary tract infections.
  • Avoid activities that can lead to internal or external bleeding, compromised blood flow, and injury to nerves and healing tissues. This includes:
    • tiring and repetitive movements
    • activities that could affect (stretch/tear) incisions (inner or outer) until your surgeon confirms that your incisions have healed
    • sudden or vigorous movements
    • lifting more than 10-15 lbs
    • strenuous activity (including sex)
    • bondage, suspension, pinching, squeezing, vigorous massage
      flogging, spanking, and paddling buttocks, thighs and other non-genital areas
    • very hot and very cold temperatures until nerves have fully healed
  • It can be helpful to speak with your surgeons before starting any kink activities in the months after surgery. Your surgeon will likely welcome these questions. If you are shy, you can be creative and ask about returning to full contact sports, swinging a tennis racket, receiving vigorous massage, riding a horse, using a heating pad or wearing restrictive or body-shaping clothing.

A note on safer sex and STI screening

Many people find that they are better able to relax and enjoy sex with others if they have spoken with their partner(s) about sexual health and STI screening.

It is possible to get sexually transmitted infections (STIs) after phalloplasty, metoidioplasty or erectile tissue release. The following recommendations can help reduce the chance of getting an STI. These recommendations are general and apply to anyone, whether they have had a genital surgery or not. Not every recommendation will apply to you, but they are helpful to be aware of:

  • Wear a condom during sex.
  • Make a habit of regularly checking that the condom has not torn or fallen off. The shaft of your penis will likely be numb for the first 12 months after surgery, so you may not feel it if this happens.
  • Ask your partner(s) to wear condoms during receptive sex (including genital and anal sex).
  • Ask your partners to have STI screening, including chlamydia, gonorrhea, HIV and syphilis.
  • Avoid having genital sex (or use condoms) if you have genital irritation or inflammation.
  • Speak with your GP or NP about how often you would benefit from getting STI screening (this is based on your sexual activities).

Learn about HIV Pre-Exposure Prophylaxis (HIV PrEP) and speak with your GP or NP if you think this might be a good option for you.