The length of your hospital stay following surgery may vary depending on the healthcare facility, and the type of surgery you have had. This is as the care your body requires will differ depending on the type of surgery. The general hospital stay and aftercare for each type of surgery are discussed below.

An orchidectomy is generally a one-day procedure. If there are no complications, you will be allowed to go home after the surgery. If necessary, you may need to stay overnight.

You may start moving around gently, immediately after the surgery. Always do this under supervision first. You will remain in hospital for 3 to 5 days after the operation; this varies depending on the healthcare facility and the individual. After 5 days, the plastic surgeon will remove the urinary catheter. As soon as you can pass urine independently on day 5, you may go home. If you are unable to pass urine spontaneously in the hours following the removal of the catheter, it will be reinserted.

You may start moving around gently, immediately after the surgery. Always do this under supervision first. You will remain in hospital for 3 to 5 days after the operation; this varies depending on the healthcare facility and how you are healing. After 5 days, the plastic surgeon will remove the urinary catheter and, if one was inserted during surgery, the gauze tampon. If you are unable to urinate spontaneously in the hours that follow, the catheter will be reinserted. You will be given advice on dilating and rinsing the vagina. As soon as you can dilate and rinse the vagina independently, and can urinate and pass stools without issues, you may go home.

Recovery from genital surgery takes months; the exact time varies from person to person. It is important that you give your body time to recover from the operation. In the period following your operation, you will need a lot of support from those around you to help with daily life (shopping, cooking, washing, etc.). We recommend that you plan this in advance. After the operation, you can’t go swimming, have a bath or visit the sauna until the wounds have healed completely. This will take at least 6 weeks. This is to prevent the stitches from dissolving too early and the wounds from reopening. Short showers are permitted. It is advised that you avoid strenuous physical activity and exercise for 6 weeks, as this can cause bleeding or excessive fluid build-up. Smoking hinders wound healing. It is strongly advised that you do not smoke for at least 6 weeks after the operation. Wait until the wounds have fully healed before engaging in sexual activity.

Following the operation you will no longer need to take a testosterone blocker; you will continue to take estradiol only. Your hormone treatment will be managed by the endocrinologist after the operation.

After the catheter has been removed, passing urine may burn. Try to avoid straining, as this causes the pelvic floor muscles to squeeze the urethra shut. Relax and take your time to empty your bladder properly; don’t rush it.

It may take a few days for your bowel movements to return to normal. It is important to prevent your stools from becoming too hard. You should therefore drink plenty of fluids each day (at least 1.5 litres) and ensure you eat enough fibres (such as fruit and vegetables). Avoid straining; particularly in the first few weeks after the operation. If necessary, hold a washcloth against the vulva to provide counter-pressure whilst passing stools. Always wipe from front to back, moving upwards from the anus towards the back.

Following vaginoplasty, you will need to dilate the new vagina. This is necessary to maintain the depth and width of the vagina. Even if wounds have formed, it is important to continue with dilation. In most cases, dilation begins 5 days after the operation. During the first few weeks after the operation, some bleeding may occur whilst dilating – this is normal and you can keep dilating. It is important to ensure that the pelvic floor muscles are fully relaxed. For the first year, dilate twice a day for at least 30 minutes each time. After the first year, you can often reduce the frequency of dilation to a level determined on an individual basis. More information can be found on the dilation page.

With a colovaginoplasty, you only need to dilate the transition from skin to intestine. The intestine itself does not need to be dilated (it naturally retains its length and width). During the first year, dilate twice a day for at least 30 minutes. After the first year, it is often no longer necessary to dilate. This is determined by you and your healthcare professional.

It is important to rinse the inside (vagina) and the outside (vulva) with water twice a day after the operation. A yellow film may form on the wound; these are proteins that promote wound healing. Do not rinse this film away. Detailed instructions for rinsing and dilation can be found on the dilation page.

The stitches will dissolve on their own over time (weeks to months). While there are wounds, wound fluid will seep out, sometimes with a little blood. Small pieces of skin from the labia and/or vagina may die off, which can cause an unpleasant odour. Keep the area clean as described above. You do not need to worry about skin tissue dying: this process does not spread to other parts of the skin.

Your healthcare provider will advise you on pain management after the operation. You can usually manage the pain with medication available from a chemist (such as paracetamol). If you are in a lot of pain, ask your treating doctor for advice.

It is not recommended to have (penetrative) sex during the first 3 months after the operation, even if you are not experiencing any symptoms or pain. It is best to discuss exactly when you can be sexually active with your plastic surgeon during your follow-up appointments, this depends on how your genitals are healing. It is also advised to first explore your own body and become comfortable with it. You can find more information about sexuality on this page.