Transfeminine Procedures

About Your Surgery

We expect our results to be good, however, complications can occur. Every surgical procedure involves a certain amount of risk, and it is important that you understand the risks involved. It is impossible for a surgeon to disclose every conceivable risk, and the following points are intended to provide information and help prepare you for surgery. Dr. Schechter will review these issues with you at the time of your consultation.

Scars result from any surgical procedure, but efforts are made to conceal or make them as inconspicuous as possible. Occasionally, excessive scarring can occur.

Signs of inflammation such as tenderness, swelling, and discoloration may last until the incisions are completely healed.

Numbness in or around the incisions may occur. Occasionally this may be permanent. Numbness may also occur in the hands, arms or legs due to the position of the body during surgery.

Infection may occur and require treatment including antibiotics or additional surgery.

Bleeding is possible during or after surgery. Should post-operative bleeding occur, it may require treatment to drain accumulated blood (hematoma) or necessitate a blood transfusion.

Wound disruption or delayed wound healing is possible. Some areas may not heal normally and/or may take a long time to heal. Unintentional interruption of blood supply to a flap, skin graft, or part of the operated area may result in its loss. Smokers have a greater risk of skin loss and wound healing complications.

Fluid accumulations infrequently occur, but may require additional procedures for drainage.

Asymmetry (noticeable difference in the size and shape) between the two sides of the operated area may result.

Rectal Injury: Inadvertent entry into the rectum may occur. This would necessitate immediate closure of the opening, closure of whatever vagina has been created, and the immediate or later creation of a colostomy (exteriorization of the colon in order that waste does not pass through the rectum).

Urethral, bladder, intestinal injury: Inadvertent entrance into the urethra, urinary bladder, or peritoneal cavity is a possibility and could cause later scar contracture or other unforeseeable problems in the future.

Stenosis: Shortening of the newly made vagina may occur due to scar contracture deep within the vaginal vault.

Blood Clots: Although rare, embolism from a blood clot may happen which could result in death.

Allergic Reactions: In rare cases, local allergies to tape, suture material, or topical preparations have been reported. Systemic reactions which are more serious may occur to drugs used during surgery and prescription medicines.

Pain: Chronic pain may occur very infrequently from nerves becoming trapped in scar tissue.

Tracheal Shave: The tracheal procedure can result in hoarseness and deepening of the voice which can, in some cases, be permanent.

Additional Surgery Necessary: Should complications occur, additional surgery or other treatments may be necessary.

Activity Restrictions:

For the first six weeks after surgery, your activity will be limited. This means no heavy lifting (no more than 10 pounds) or strenuous exercise. Six weeks after surgery, you may resume all of your usual activities, including exercise. Vaginal intercourse may begin eight weeks after surgery.

Dilator Care:

  • Soak the dilator in a betadine solution for no more than 10-15 minutes prior to use
  • Wash the dilator with an antibacterial hand soap after each use

Post-operative Douching Instructions (typically performed in the shower):

  • Place a few drops of an antibacterial liquid soap in the douche bag and fill with warm water.
  • Insert the tip of the douche a few inches into the vagina and gently squeeze the bag.
  • Repeat this process with clear water to remove the soap residue.
  • This should be performed daily for two weeks after discharge from the hospital. After this time, douching should be performed two to three times each week.
  • A yellowish-brown discharge may be noted for the first few weeks after surgery. In addition, you may notice sutures and debris in the discharge.

Vaginal intercourse:

Vaginal intercourse may begin eight weeks after surgery.

Follow-up Care (prostate exam):

An annual speculum and prostate exam should be performed.