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Phalloplasty for Gender Affirmation: What to Expect at Home

After phalloplasty for gender affirmation: Overview

Phalloplasty (say "FAL-oh-plas-tee") is surgery to create an average-sized penis, or phallus. To do this, the surgeon used tissues from your genitals and from your forearm, belly, or leg. You may have had other procedures too. For example, the surgeon may have used tissue from your body to lengthen the urethra or to create a scrotum. It may take several surgeries done over time to get the results you want.

You may have a skin graft. This means the surgeon used skin from another part of your body (donor site) to replace the skin used to create the penis. If so, you'll have bandages over the skin graft and the donor site. These areas are likely to be sore for a few weeks. Your doctor may give you other instructions on how to care for these wounds.

You may need a urinary catheter for a short time. This is a flexible plastic tube used to drain urine from your bladder. If the catheter is still in place when you go home, your doctor will give you instructions on how to care for it.

You will probably feel better and stronger each day. But you may get tired easily or have less energy than usual. This may last for several weeks after surgery.

The surgical area will be bruised and swollen. Most of the bruising will go away in 2 to 3 weeks. Most of the swelling should go away in 6 to 8 weeks.

It's important to avoid heavy lifting while you're recovering so that you can heal. Your doctor may give you specific instructions to follow. It may take at least 6 to 12 weeks to return to your usual activities. It may take several months to fully recover.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

Activity

Allow your body to heal. Don't move quickly, lift anything heavy, or do any strenuous activities, such as biking, weight lifting, or aerobic exercise, until your doctor says it's okay.
Follow your doctor's instructions about sitting while you're healing. For the first 4 weeks after surgery, you may need to avoid sitting and to avoid flexing your hips more than 45 degrees.
Rest when you feel tired. Getting enough sleep is needed to help you recover.
Be active. It can help prevent problems and help you recover. Short and frequent activity is ideal. Walking is a good option for many. Tell your doctor right away if you develop discomfort, pain, or changes in your surgical area.
Ask your doctor when you can drive again. Do not drive if you have pain or you're taking prescription pain medicines.
Ask your doctor when it's okay for you to have sex.
Your doctor will tell you when you can return to work. This will depend on the surgery you had and the type of work you do.

Diet

You can eat your normal diet. Be sure to include plenty of protein. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
You may not have much of an appetite right after surgery. Even if you don't feel like eating, make sure you drink enough fluids and stay hydrated.
If your bowel movements are not regular right after surgery (this is very common), try to avoid constipation and straining. Drink plenty of water. Your doctor may suggest fibre, a stool softener, or a mild laxative.

Medicines

Your doctor will tell you if and when you can restart your medicines, including hormones. You will also get instructions about taking any new medicines. If you have any questions about your medicines, talk to your doctor or a pharmacist.
If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
Be safe with medicines. Read and follow all instructions on the label.
- If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
- If the doctor gave you a prescription medicine for pain, take it as prescribed.
- Store your prescription pain medicines where no one else can get to them. When you are done using them, dispose of them quickly and safely.
If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision and wound care

You may get a special dressing or underwear to support your penis while it heals.
You may have dressings over the surgical wounds. A dressing helps them heal and protects them.
Follow your doctor's instructions for keeping the surgical wounds clean and dry.
You may have stitches over the cuts (incisions). If your doctor gave you specific instructions on how to care for your incisions, follow those instructions. Your doctor will tell you if you need to come back to have the stitches removed.
Ask your doctor if you can use a cold pack or warm compresses on your surgical sites.
If you have a skin graft, follow your doctor's instructions on how to change the bandages and when you don't need them anymore.
Your doctor will tell you when you can take a shower. Do not take a bath, swim, or use a hot tub for the first 2 weeks, or until your doctor tells you it is okay.
If you have a drain after surgery, your doctor will tell you how to take care of it.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

You passed out (lost consciousness).
You have chest pain, are short of breath, or cough up blood.
You can't stop bleeding from the surgical site.
You have extreme weakness or fatigue (to the point where it's hard for you to function).

Call your doctor or nurse advice line now or seek immediate medical care if:

You are sick to your stomach or cannot drink fluids.
You have pain that does not get better after you take pain medicine or pain that continues to get worse.
You cannot pass urine, or you have pain when urinating.
You have loose stitches, or your incision comes open.
You have signs of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the incision.
- Pus draining from the incision.
- A fever.
You have signs of a blood clot in your leg (called deep vein thrombosis), such as:
- Pain in your calf, back of the knee, thigh, or groin.
- Swelling in the leg or groin.
- A colour change on the leg or groin. The skin may be reddish or purplish, depending on your usual skin colour.
You have changes in the genital area, such as a change in colour, temperature, or drainage.
You cannot pass stools or gas.
You have belly pain or bloating, or you have to strain to have a bowel movement.
Bright red blood has soaked through the bandage over the incision.

Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if you have any problems.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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Current as of: April 30, 2024

Author: Ignite Healthwise, LLC Staff

Clinical Review Board
All Ignite Healthwise, LLC education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.

Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Ignite Healthwise, LLC disclaims any warranty or liability for your use of this information.