What is vulvoplasty (gender affirming care)?

Vulvoplasty (Gender Affirming Care)

How can you care for yourself after vulvoplasty for gender affirmation?

Activity

  • Allow your body to heal. Don't move quickly, lift anything heavy, or do any activities until your doctor says it's okay. This includes walking, jogging, biking, weight lifting, and aerobic exercise.
  • Rest when you feel tired. Getting enough sleep will help you recover.
  • Be active if your doctor says it's okay. It can help prevent problems and help you recover. Walking is a good option for many. Talk to your doctor before you begin any activity, including walking. Tell your doctor right away if you develop discomfort, pain, or changes in your surgical area.
  • Your doctor will tell you when you can return to work. This will depend on the surgery you had and the type of work you do.
  • If it hurts to sit, try sitting on a donut-style pillow or leaning back (reclined).
  • Ask your doctor when it's okay for you to have sex.
  • Ask your doctor when you can drive again.

Diet

  • You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
  • If your bowel movements are not regular right after surgery, try to avoid constipation and straining. Drink plenty of water. Your doctor will likely suggest fiber, a stool softener, or a mild laxative.

Medicines

  • Your doctor will tell you if and when you can restart your medicines, including hormones. The doctor will also give you instructions about taking any new medicines.
  • If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
  • Be safe with medicines. Read and follow all instructions on the label.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • Store your prescription pain medicines where no one else can get to them. When you are done using them, dispose of them quickly and safely. Your local pharmacy or hospital may have a drop-off site.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

  • Follow your doctor's instructions for how to care for your incision.
  • Keep the surgical areas clean and dry. Wash the area daily with warm water, and pat it dry. Don't use hydrogen peroxide or alcohol. They can slow healing.
  • You may have one or more drains. Your doctor will tell you how to take care of them.
  • While you're healing, wear the type of underwear your doctor recommends.

Ice and elevation

  • You can try using ice on the area to help with swelling and soreness. Find out what your doctor recommends.

Hygiene

  • Your doctor will tell you when you can take a shower. Do not take a bath, swim, or use a hot tub until your doctor tells you it is okay.
  • Wash your hands before and after contact with the genital area.
  • Gently pat dry front-to-back after going to the bathroom.

Other instructions

  • Use pads for any spotting or drainage.

After vulvoplasty for gender affirmation: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have severe bleeding that won't stop.
  • You passed out (lost consciousness).
  • You have chest pain, are short of breath, or cough up blood.

Call your doctor now or seek immediate medical care if:

  • You are sick to your stomach or cannot drink fluids.
  • You have pain that does not get better after you take pain medicine.
  • You have loose stitches, or your incision comes open.
  • You are bleeding from the incision.
  • Bloody drainage from a drain increases or won't stop.
  • You have bruising and swelling that gets worse.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • A fever.
  • You have signs of a blood clot in your leg (called deep vein thrombosis), such as:
    • Pain in the calf, back of the knee, thigh, or groin.
    • Swelling in the leg or groin.
    • A color change on the leg or groin. The skin may be reddish or purplish, depending on your usual skin color.
  • You have symptoms of a urinary tract infection. These may include:
    • Pain or burning when you urinate.
    • A frequent need to urinate without being able to pass much urine.
    • Pain in your lower back (below the rib cage and above the waist).
    • Blood in your urine.
  • You cannot pass stools or gas.

After vulvoplasty for gender affirmation: Overview

Vulvoplasty is surgery to create a vulva. The vulva includes the labia, clitoris, and urethra. This surgery does not create a vaginal wall. The doctor most likely used the scrotum to form the labia. The head of the penis was used to create a clitoris. The urethra was shortened and placed below the clitoris.

You may need a urinary catheter for about 3 to 5 days. This is a flexible plastic tube used to drain urine from your bladder. If the catheter is still in place when you go home, your doctor will give you instructions on how to care for it.

The surgical area will be bruised and swollen. Most of the swelling should go away in 6 to 8 weeks. You may also have some drainage or spotting for a month or more.

You will probably feel better and stronger each day. But you may get tired easily or have less energy than usual. This may last for several weeks after surgery.

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