Male to Female Surgery Post-Op Care deserves emphasis well before GRS Vaginoplasty Surgery. If you are from out of town, you will need to establish a relationship beforehand with a physician knowledgeable in pelvic anatomy, ideally a urologist, gynecologist, plastic surgeon or family doctor whose practice caters to transsexual care. This doctor should feel comfortable removing sutures on the 14th post-op day and not hesitate to confer with Dr. Reed as needed.
Plan on bringing a female friend who can be present during all discussions and post-op visits with Dr. Reed. Your friend will be able to see things from a different perspective, more as a treating physician, especially during dilation, and can follow you for several days to be sure you are doing it properly.
Purchase a ring pillow or U-shaped pillow in advance, Use it when you are seated at all times as a torso weight in excess of 100 pounds will certainly split your incision lines. In an emergency, 2 folded bath towels, one under each lateral buttock will do,
Your packing will be removed on the 7th post-op day at the office. Expect a minor amount of spotting, and this may be aggravated with stent or vaginal dilator usage. Some vaginal discharge is to be expected. You can place an absorbent pad over the labia, but please not paper products in the vagina, as Pseudomonas (green) bacteria has a love affair with paper (“The Toxic Shock Syndrome”)
We suggest a set of 6 dilators with curved tips and dot markings to indicate depth achieved. When inserting these stents, lie down flat and the shank or handle of the stent has to be parallel to the floor. Aim the tip toward your belly button. Pushing downwards can create a rectal perforation or vaginal-rectal fistula. Do call your transgender surgeons with any concerns. Most fistulas will respond to conservative treatment.
Some minor inflammation and superficial infection may occur, but taking antibiotics indiscriminately can result in an overgrowth of resistant orgasms. Your doctor will provide a douching kit with a Toomey syringe and soft red rubber catheter. For the first week daily douches are encouraged. After recovery you will probably need to douche every so often as your penile skin inversion or scrotal vagina does not have a muscular wall as with natal women. The position of the American Gynecology Association is that natal women do not have to douche as slow vaginal contractions evacuate any mucus and post-menstrual discharge. (Optional of course). We say for reasons of hygiene douche as needed.
Compliance with your experienced doctor’s instructions for Male to Female Post- Op Care does make a difference.
Harold M. Reed, M.D.
The Reed Centre for Transgender Surgery – Miami
Vaginal Dilators are passed somewhat upwards