FTM Bottom Surgery Recovery Tips

Quit smoking at least 2 months prior to your surgery and during your recovery to minimize complications from occurring. Smoking affects healing by restricting oxygen and blood from traveling to the wound to repair and build cells. Using tobacco lowers blood oxygen levels, which could cause failure or delayed healing of the skin and wound infections, resulting in worsening the appearance of surgery scars and skin discoloration.

Being fit/healthy before surgery could play a major role in how your body will recover. How healthy you are will determine the length of your recovery time and amount of complications you could experience. Before having bottom surgery, try to maintain a healthy weight and lifestyle. 

Slip-on shoes, such as slippers, flip-flops, or boat shoes prevents the need of reaching down and having to tie shoelaces, which could strain incisions.

Bending straws could reduce strain to incision sites while drinking fluids or taking post-op medications during recovery. 

Consider using a donut cushion to relieve pressure/pain and prevents the risk of suture tearing/complications from surgical sites, such as genitals when sitting.

Note: Avoid sitting for long periods of times to reduce pressure on your genitals. 

Adult washcloths & no rinse body bath/shampoo could help keep your body feeling clean to support the healing process while preventing water from directly touching incision sites, dressings, and drains.

Alcohol pads clean any unwanted residue on the outside of your catheter and can be used to disinfect medical items (e.g. surgical scissors, forceps) before and after use. It is recommended to use alcohol pads to clean the catheter drainage tube, drainage bag, and end of the catheter tube to reduce the chances of having a urinary tract infection. For example, when changing your catheter daytime leg bag with your night bag, make sure to wipe all tubing and catheter connections with alcohol wipes before taking apart and before reconnecting.  

Wound cleanser cleanses wounds, including where the catheter exits from your body, such as individuals wearing suprapubic catheters. It helps prevent bacteria growth caused by moisture that can lead to infection. 

Gauze could be placed over your catheter exit-site. If you are wearing a suprapubic catheter, cushion the catheter exit-site with gauze pads and use medical tape to hold the gauzes in place. Be sure to clean your catheter exit-site daily with wound cleanser and saline wash to aid in preventing infection. It is also used to absorb leakage, keep the area dry, lessen movement of the catheter, and minimize the risk of infection.  

Maintaining a dry genital area as much as possible could prevent infections from occurring. When laying in bed, try to leave your genitals exposed to open air. 

Medical tape/catheter tube holders can be used to secure the catheter, aiding it from being tugged or accidentally pulled out, which could cause damage to the bladder. 

Scar reducing silicone tape/sheeting/oils/creams could reduce the appearance of post-op scarring. It has been successfully used by many individuals who have undergone bottom surgery.

Note: It is essential to massage scars once they have healed. Massaging your healed scars in the direction of the scar could help stimulate blood circulation and promote tissue flexibility that surrounds the surgical site. 

Mesh underwear is a reusable/disposable light underwear that allows air through groin area/surgical site, aiding in preventing excessive moisture buildup, wound and urinary tract infections, chafing, and pressure to phallus caused from adult diapers and other undergarments. Use along with a pad to avoid leakage through the underwear.

Underpads could be used on top of beds and furniture. It aids in capturing drainage from surgical sites, flakes of dried blood from skin grafts, and reduces contaminants entering wounds from the bed/furniture. Useful during wound care and when sitting/sleeping.

Charles Archer underwear may be considered for individuals who lack support from wearing regular boxers/briefs. It is highly recommended by post-op phalloplasty patients and gender reassignment surgeons, as it provides extra support for guys with large girth phalluses.

Bladder spasms could occur while wearing a catheter. To prevent or reduce these from occurring, take your prescribed bladder spasm medication as needed, if your healthcare provider prescribed you one. If you don't have any, ask your healthcare provider to prescribe you one. If your bladder spasm medication is ineffective, consider notifying your doctor for recommendations or try to avoid spicy foods, carbonated beverages, acidic, and citrusy foods that could irritate your bladder. For example, peppers, soda, chocolate, pickled foods, and oranges. If your bladder spasms still occur and have not improved in any way, notify your healthcare provider immediately to be evaluated for a possible urinary tract infection. 

Catheter care is essential during the recovery process. Ensure that your catheter tubing is not bent in any way that could block the flow of urine, which could result in causing bladder spasms. Additionally, ensure your drainage bag is lower than your bladder to prevent urine from being drained backup into your bladder and causing a risk of having a urinary tract infection. 

Note: If wearing a leg bag, try to empty your bag every 2-3 hours to reduce the chances of the weight of the urine pulling on the catheter. 

A Catheter plug could be instructed by your surgeon at some point during your recovery. If you have to start plugging your catheter and begin peeing out of your phallus, after urination, it is necessary to unplug your catheter plug from the catheter tube in order to release the remaining urine from inside your bladder. You may feel a discomfort pressure coming from your bladder when draining your remaining urine into the toilet. 

To reduce the discomfort feeling, while you remove your catheter plug, squeeze the end of the catheter tube from where it meets the catheter plug with one hand and using your other hand, slowly twist the catheter plug in a right to the left motion to gradually remove the catheter plug. Continue squeezing the end of the catheter tube even after the catheter plug has been removed. Slowly ease off from squeezing the catheter tube. While easing off from squeezing the catheter tube you may hear air and see small amounts of urine escaping from the catheter tube. 

Slowly ease off from completely squeezing the catheter tube, such as allowing the opening of the catheter tube to be opened halfway to release your urine slowly down into the toilet. While your remaining urine is being drained into the toilet, adjust the way your catheter tube is being squeezed. Squeeze it accordingly to your comfort of how much pressure you feel from urine being released from your bladder. By slowly releasing the remaining urine from your bladder will reduce the discomfort pressure feeling caused by the urine exiting your catheter. 

Difficulties of urine draining from your catheter drainage bag/tube could occur. If you start to feel discomfort due to feeling pressure from your catheter or feel bladder spasms, observe your catheter tube to see if there is a lot of urine stuck between the tube. If urine is backed up, place your catheter bag flat on the floor. Note: Before placing your catheter bag onto the floor, cover it with a clean bag. After placing your catheter bag onto the floor, extend your catheter tube until the tube is completely straight or until urine starts to drain into your catheter bag. Doing so could relieve any bladder discomfort/bladder spasms. 

Medihoney could be used to heal common wound complications, such as fistula. It is highly recommended by post-op phalloplasty patients and gender reassignment surgeons to treat post-operative wound complications with this natural product.

Infection could occur at anytime post-op. It is important to check for any signs of redness, tenderness, heat, foul odor, and/or discharges, such as pus at incisions. If you notice any signs of infection occurring, notify your healthcare provider immediately to obtain further care instructions or treatment.