How Long Will I Stay in the Hospital?
Plan to stay in the hospital for at least 5 days after your surgery.
For example, if your surgery is on a Monday, you should plan to stay through Saturday.
You may need to stay longer if the surgery team has any concerns that require you to be cared for in the hospital. For example, you may need to stay longer in the hospital if you have:
- infection,
- phallus blood flow issues,
- bleeding, or
- you have a hard time eating or drinking because of nausea, pain control problems, or other issues.
Your surgery team will discuss all plans with you.
Managing Pain
You will have a “pain button” or patient controlled anesthesia (PCA) button. This will let you control delivery of pain medicine when you need it.
Days 1 & 2 in the Hospital
- After your first 24 hours in the hospital you’ll slowly be given a diet to make sure you are not nauseated.
- You will be given sequential compression devices (SCDs) on your legs, which gently squeeze your legs and help prevent blood clots.
- You will be given a daily aspirin to help prevent small clots from forming at the blood vessel connections to your penis and groin area.
- You’ll start taking home medications as soon as possible, depending on what these medications do.
Days 2 & 3 in the Hospital
For the first 2-3 days after your phalloplasty, you will stay in a special hospital unit where you will be checked on every 1-2 hours.
The surgery and nursing team will check your phallus (penis’) color, capillary refill, temperature, and doppler signal.
A doppler machine will be at your bedside and is attached to a wire that ultimately is attached to a probe around the blood vessels that supply your penis. The doppler and frequent exams help your team make sure that your penis is getting enough blood flow. This helps us make sure that if there’s a problem with your phalloplasty, we catch it early and act quickly.
You won’t be allowed to eat or drink for the first 24 hours after your surgery. This is because you may need to return to the operating room in the case there’s a problem with your phalloplasty.
We hope these frequent checks help you feel comfortable and that you’re getting the care you need.
Blood Flow & Phalloplasty Surgery
Your penis will be elevated on a special dressing to make sure that blood flow isn’t blocked. As you can tell, blood flow is extremely important for a successful phalloplasty. We take great care to make sure your new penis is getting the blood flow it needs.
Days 3—5 in the Hospital
3 to 5 days after your surgery, you’ll be transferred a less acute surgical unit where you’ll be checked on less often.
On day 5:
- Your skin graft VAC dressing will be removed and then redressed with Xeroform gauze, kerlix gauze roll, and your splint
- Your groin and scrotum drains will be removed
- The doppler wire will be cut
- You will be given supportive underwear (you can bring your own, but it must be OK’d by the surgery team to make sure it’s adequate)
You will be allowed to walk with assistance. Physical therapy may be involved in your care to help with this transition and give suggestions to help you get around.
Urinating With a Catheter
A suprapubic catheter (a tube placed through your skin above your pubic bone and into your bladder) will drain your bladder for the first few weeks after surgery. The urology members of the team will manage this catheter.
There will also be a red catheter in your penis which will hold your new urethra in an open position. Your surgical team will remove this catheter before you leave the hospital.
Drain Care
- Your scrotal drain will usually be removed before you leave the hospital
- The Penrose drain will usually be removed from your groin area while you’re staying in the hospital
- The VAC dressing will usually be removed on post-op day #5
- IV catheters will be removed before you leave the hospital
