You will be admitted to the recovery residence in Montreal two days before your surgery. After your surgery, you will stay in hospital for three nights. Then you will return to the recovery residence for seven days.
You will likely receive painkillers and antibiotics to prevent infection. Your surgeon will provide you with a list of medications to avoid for the first month. Do not resume taking hormones until your surgeon has advised you to do so.
During the healing process, you can expect:
- bleeding during the first 48 hours following surgery
- itchiness and small shooting electrical sensations as nerve endings heal
- bruising, which can spread from your belly to your thighs and which takes 3 to 4 weeks to settle down
- a bit of spraying when you urinate, which usually improves over time
- swelling of your labia, which can take up to 6 weeks to resolve
- brown or yellow vaginal discharge for the first 6-8 weeks
- your vulva to approach its final appearance at 4 months
- numbness, which will improve over the first few months, and can take up to 18 months to resolve
- red, dark pink or purple scars, which take up to one year to fade
A urinary catheter will be in place for the first five days after surgery to allow you to pass urine while your urethra heals. Sometimes people still aren't able to urinate when the catheter comes out, due to swelling around the urethra. This situation can easily be resolved with a second catheter that will remain in place for a week and be removed by your physician when you go home. You'll be encouraged to drink lots of fluids to prevent urinary tract infections.
A prosthesis or stent will be placed in your vagina during surgery and will remain there for 5 days to make sure the skin grafts stay in place. When it's removed, you will begin dilating and douching.
A vaginal douche is a process of rinsing the vagina by forcing water or another solution into the vagina to flush away vaginal discharge or other contents. The nurses in Montreal will show you how to douche.
You will be given a set of vaginal dilators of different sizes. You'll use them to maintain vaginal depth and width and promote healing. The nurses will teach you how to use your dilators and give you a schedule to follow. Initially, you'll dilate several times a day and over the first year the amount of time spent dilating will be gradually reduced. After you have completely healed, you will only need to dilate about once a week. The frequency depends on how much penetrative sex you have.
For the first two months after surgery, you will take sitz baths. A sitz bath is a way to soak your surgical site to keep it clean. Your nurses will provide you with the equipment and show you how to use it.
You'll want to wear thin maxi pads for about one month to manage post-operative bleeding and discharge.
The number of check-ups needed varies from person to person. If possible, see your primary care provider about a week after you return from Montreal and then every 2-4 weeks for the first few months. When you visit your surgeon or primary care provider, they should check your surgical sites to make sure there are no infections or wound healing problems. They will ask questions about dilating, bleeding, vaginal discharge, fever, pain and how you are feeling emotionally and physically.
Recovery time varies from person to person, so always follow the advice of your surgeon. Many people begin to feel more comfortable during the second week after their surgery.
You'll need plenty of rest in the first two weeks. It's common to be back to your usual activities, including work, in six to eight weeks. Some activities, such as driving, heavy lifting, exercise, sex, and soaking in hot tubs, may be restricted in the post-operative period.
Your surgeon will give you advice about when it is okay to resume these activities. Complete recovery can take up to one year.
A surgical revision of a vaginoplasty, if needed, would typically takes place 6 to 8 months after your surgery is complete. With a letter of recommendation from your surgeon, the cost of your revision will be covered by MSP.
Common reasons for a surgical revision include:
- To adjust the size, shape, location or hooding of the clitoris
- To adjust the size or shape of the labia minora or majora
- To deepen the vagina