Going Home after Gender Reassignment Surgery
a patient's guide to surviving this operation, please download Steph's
tips; she was my patient in 2004, and has some very useful advice.
Now that you’ve had your operation, and are going home, I
hope and expect that there will not be any problems. I do however recognise that some patients will need to make
contact regarding queries and or problems which concern them before the date of
their follow up clinic. If you are
worried about anything, I would suggest you try the following;
Go to see your GP.
Although the surgery is highly specialised, my experience is that most
GP’s manage superficial infections and similar problems very well. Your GP will also be able to contact me
for advice if he/she is concerned.
Call the ward in the Hospital where you had your
operation. Many problems are
easily sorted out over the phone by an experienced member of the nursing
staff. They will also be able to
ask me for advice.
Call me! The
phone line to my Office is open 24 hours a day (020 8241 1637). If the office is unmanned, you will be
given instructions by the answering machine to enable you to make contact with
me. Less urgent queries may be
dealt with by email. Between 9.00
and 4.30, my NHS Secretary (020 8483 2866) will usually be able to track me down (but be prepared for a Texan diatribe!).
Clearly, there may be occasions at weekends or during the night,
when you feel that more urgent care is needed. Even then, it is often best to try to see your GP first, or
contact the ward for advice. If
neither of these is possible, you may need to go to your local hospital
Casualty Department. If you do
this, please take this sheet with you, so that contact numbers and names are
available to the staff who see you.
On the (very rare) occasions when I am not personally available, I will
have left contact details for another extremely experienced surgeon who should
be able to help.
Care for your new anatomy
you left hospital, I will have shown you how to use the dilators. Initially, these should be inserted 3
times a day. Use the small dilator
first, leave it in for 5 minutes after pushing it as far as it will go
comfortably, then insert the large dilator and leave it in place for a minimum
of 10 minutes. The process is
often uncomfortable at first, and may be accompanied by a small amount of bleeding. Many patients find it easier to dilate
in the bath, and this is quite acceptable. Usually by 2 months it is possible to reduce the frequency
to twice daily, and you will know that this is the case if dilation is becoming
very easy. Initially drop the
“lunchtime” dilation. If the
evening dilation is still relatively easy, you can safely go down to twice a
day. Similar reductions in
frequency at around 4 and 6 months are usually possible, so that most patients
are only dilating 2 or 3 times a week by 9 months. These are general rules only, however, and there is great
variation between individual patients, so you should try out each reduction in
dilation frequency for yourself, and be prepared to stay on a higher frequency
for longer if necessary. Remember
that you need to keep dilating for the rest of your life!
possible, you should bathe twice daily for the first month to 6 weeks. There is often a little infected
looking matter on the surface, which may easily be removed by gentle washing
with water and simple soap. Strong
detergents are best avoided, as are strong antiseptics, although there is no
harm in very dilute “Dettol” or similar
in the bathwater if you wish. You
should aim to douche daily for the first month. In my view the best solution to use is mains tap water (i.e.
from the kitchen tap), as this is nearly bug free. You should have been given a suitable syringe before you
went home. After the first month
douche as often as you feel hygiene requires; many patients find they can stop
Sex. It is
unusual for patients to feel up to sexual contact within 2 months of the
operation, and, while healing is still in progress, sex should be avoided. If the inclination and opportunity
arise after 2 months you should be able to start gently and with care.
Hormones may safely be restarted on discharge from the hospital. You will typically need only one third
to one half of your preoperative dose.
You will no longer need to take anti-androgens such as Cyproterone,
Casodex and Finasteride, and these can be discontinued. Your final dose of oestrogen may be
tailored to your needs by the person who supervised your pre-operative hormone
therapy (typically your GP or Psychiatrist). There is further information in the homone leaflet in the downloads page.
Download this information as a pdf file (Open with