Aftercare
This section provides information on how to care for yourself after you leave hospital, including a description of what happens in the period following your surgery and what you can do yourself to further aid your recovery.
Directly after your operation
The duration of hospitalisation after surgery may differ per clinic, and the care that your body requires differs per operation. Below, the general stay in hospital and the aftercare are discussed for each type of operation.
Orchidectomy
Orchidectomy, in principle, is an outpatient operation, which means that, if there are no complications, you will go home after the operation. However, if necessary, you may stay overnight. More detailed information about the aftercare for orchidectomy can be found here.
Vulvoplasty
After the operation, you will need to stay in bed for 3 days. After 3 days, your plastic surgeon will removed your catheter. If, after a few hours, you are not able to urinate, the catheter will be reinserted. As soon as you are able to pass urine properly without the catheter you will be allowed to leave hospital. More detailed information about the aftercare for vulvoplasty can be found here.
Vaginoplasty
After the vaginoplasty, you will stay in hospital for another 5 days. The first 3 days you must stay in bed, and it is recommended that you move as little as possible. After 5 days, the plastic surgeon will remove the urinary catheter and, if applicable, the tampon. If , in the following hours, you are unable to urinate properly by yourself, the catheter will be reinserted.
Advice for at home
The recovery process after genital surgery may take a long time. It is important for your body to have the time to recuperate from the operation. In the period that follows, you will need some outside support in day-to-day life (grocery shopping, cooking, laundry, etc.).
In the first two weeks after surgery, you are not allowed to swim, have a bath or visit the sauna. This is to prevent the stitches from dissolving too early and the wounds from opening up. Brief showers are allowed. You are not allowed to exercise or lift heavy objects for six weeks, as this may cause bleeding or the build-up of excessive fluids. In addition, you are strongly advised not to smoke following your operation, for at least three months.
Hormone use after the operation
After the operation, you will stop taking testosterone blockers. You will only continue taking oestradiol. The hormone treatment following the surgery will be supervised by the endocrinologist.
Urination and defaecation
After the removal of the catheter, urinating may cause a burning sensation. Try to avoid forcing it, as this will in fact squeeze and close the urethra. Take the time to urinate properly, do not rush.
It may take a few days for your stools to return to normal. It is important that you prevent them from becoming too solid. Therefore, drink enough fluids every day (at least 1.5 litres) and make sure you eat a high-fibre diet. Avoid pressing down, especially not in the first weeks after surgery.
Dilation and vaginal douche
Dilation
After a vaginoplasty, you will need to dilate the new vagina. This is necessary to maintain the depth and diameter of the vagina. Even if wounds have occurred, it is important to keep moving and to continue dilating. In the first weeks after surgery, blood may be released during dilation, but you will need to continue to dilate. It is important to ensure good relaxation of the pelvic floor muscles.
Dilation after penile inversion vaginoplasty
After a penile inversion vaginoplasty, you will start dilation on the 5th day after your surgery, at which time you are probably still in hospital.
Dilation after bowel vaginoplasty
After a bowel vaginoplasty, you will only need to dilate the transition area from skin to bowel — the bowel itself does not need to be dilated (it will naturally retain its length and diameter).
Vaginal douche
After the operation, it is important to rinse the external areas and use a vaginal douche. A yellow film may form on the wound itself; this is a layer of proteins that promote healing, so do not remove this film.
Detailed instructions on douching and dilation can be found on the Dilation page.
Wound healing
The sutures will dissolve by themselves, in time (weeks to months), even if a wound opens up a little. As long as there are wounds, there will be some discharge, sometimes with some (old) blood. Small pieces of skin can die off from the labia and/or vagina, which can give an unpleasant odour. Keep the area clean as described above. You do not have to worry about the dying tissue; this process will not spread to other areas.
Painkillers and medications
- Painkillers — Paracetamol (maximum 4 x 1000 mg per day) is often sufficient to suppress pain and/or discomfort. Paracetamol has the most impact when taken at set times. If paracetamol is not strong enough, your physician will provide you with a subscription for additional painkillers.
- Prescriptions — Medications can be picked up from the hospital pharmacy. You can also have the prescription sent to your own pharmacy to be picked up from there. You will be able to indicate which of these two options suits you best, when you are discharged from hospital.
- Hormones — You may continue taking oestrogen as you did before the operation, but can stop taking the testosterone blockers.
Sexuality
Whether you will be able to enjoy sex after your operation is difficult to say. This is not only a physical matter, but also depends on how you are feeling. Are you happy with your body and yourself in general? Are you able to relax? If you are intimate with another person: do you feel at ease in the presence of this other person. Do you really like this person?
You can also try and get to know your own body a little better by trying out how certain pleasurable areas respond. For example:
- Do you like firm or soft rubbing? Pressure? Moving in circles?
- Do you enjoy using a toy?
- Do you use lubricants and, if so, which type do you like the most?
- Do you become aroused when you fantasise about something during intimacy?
Often, it is easier to achieve an orgasm through masturbation than when you are intimate with someone else.
Sexuality is important for many people after genital surgery. It is not recommended to have sex in the first 3 months after the operation (even if you do not experience any symptoms or pain). After that, it is important to first familiarise yourself with your body before allowing anyone else to join in. It would be best to talk to your plastic surgeon, during your follow-up examinations, about whether your genitals have recovered sufficiently for you to be sexually active again.
This text was edited on 9-9-2022
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Dilation
Dilating is necessary to keep your new vagina open and deep if you have chosen for a vaginoplasty. Read about what exactly dilating entails here.
