2-7 weeks post stage 2 update!
Hello! Thought it was about time for an update. Time has gone by incredibly quickly. I’ve been pretty preoccupied with life stuff and honestly stage 2 recovery was pretty uneventful once I was out of the hospital and resting. Strap in though, as this is gonna be a long one.I think the best way I can update you all is by doing a rough update of the past few weeks, and then I will talk specifically about the healing of each section.
GENERAL HEALING FROM 2-6 WEEKS
My last update was from 2 weeks post op, so feel free to go back to that if you want some context. Following that update, I had my first appointment at the continence clinic for my first void trial! I got to the clinic at 7:30am, and this was located at Greenslopes. Goossen came in and had a bit of a look and took my urethral catheter out- he said there wasn’t any resistance which was a good sign. I was then taken to the waiting room area and given some water...and then it was time to wait.
The room itself was quite nice, there were a huge selection of recliners and some TVs, and nurses who were offering food and coffee while I waited. I had my 2L bottle of water and just started chugging. Once I felt the urge to pee I went to the bathroom, and on a table was a selection of bottles all labelled with peoples names. I located my own and then had my first attempt and it went well! I was expecting it to hurt or be uncomfortable, but it didn’t hurt very much at all, possibly because I was so well hydrated. I then went to the consulting room and had an ultrasound on my bladder to see whether or not I completely emptied my bladder. The nurses then measured how much I peed to see if it was all normal. All was looking good so I was sent back into the waiting room for another 2 attempts before I’d be cleared to leave. The other two attempts went off without a hitch and so I was sent off back home, with my SPC being switched to a flip flow instead of a bag. From now on, I will be solely voiding from my penis, but if there is any issue like a stricture or for whatever reason I can’t pee, I have the SPC as a backup option.
The rest of this week was pretty uneventful. The only issue I noticed post urethral catheter removal was that the next few days I had a few issues with bladder spasms, but it passed pretty quick and wasn’t an issue again as long as I took my ditropan. I was oozing less and less, eventually to the point where I only needed 2 pieces of gauze on my scrotum and no more giant pads, and the best part...normal underwear instead of the hospital ones I’d been wearing for 2 weeks 🥰. I just chilled at home, drinking my water and peeing when I needed to- and thankfully there were no issues. I didn’t need to use the SPC at all, and now that it wasn’t being used and I was back to normal underwear it was actually not too bothersome. My family returned to Hong Kong and so I didn’t do too much besides waiting for my next appointment so I could go home. At this point, I was pretty much off pain meds besides random instances of pain or if I overdid it.
On Tuesday I had the SPC removed. This was also at the continence clinic at 7:30am. The nurses started to remove it but found that it wasn’t coming out. They were trying to be very gentle and unfortunately it wasn’t budging. They decided they would wait until Goossen came in to do it. In typical fashion, he removed it in 2 seconds with a few solid tugs. Luckily for me, it was so quick that I didn’t really have time to register what was happening and that it hurt before it was all over, lol. My drainage hole was dressed and I was told to contact him or the hospital if I had any issues. He stressed that I am not to be catheterised by my urethra unless it is done via camera and by someone with experience, and if not to just get an SPC, or, in case of emergencies, a large needle through my spc scar to aspirate urine if I can’t be catheterised. After shuddering at the thought of that I was all set to go and I was cleared to go back to Melbourne the next day.
My flight home was fine. I was a lot more mobile this time around compared to how I was post stage 1, and although I was taking it easy travelling didn’t completely wipe me like it did last time. I had some panadol just to manage my pain during the trip, but I don’t think I really needed it. I was feeling pretty back to normal now at 4 weeks post op, and boy was I glad to be home. I spent a few days relaxing, and then started back into GAMSAT study which took up the majority of my time.
The GAMSAT was last week, I was 6 weeks post op. For those unfamiliar, it is an exam you need to take to apply for most postgraduate medicine programs and consists of 3 sections that total about 5.5 hours. It’s a mammoth of a day for anyone, let alone someone who had a 6 hour surgery not even 2 months prior. I was feeling pretty back to normal luckily, and I think it went okay…but I’ll find out in November. I applied for accommodations before surgery as I was unsure how I’d be feeling post op, and so I was allowed to bring some pain meds in just in case, as well as a pillow to sit on. Apparently this was a strange request as when I entered the room the lady went “Oh! You’re the pillow man!” lol. I was actually seated in a separate section to the other people sitting the exam due to my accommodations, which was nice as it meant the whole process was smoother and there was less waiting around which I think was good for my body as I was getting a little sore towards the end. I’m just glad it’s all over now!That is about it for my general update, now I’m going to go specifically into how the different wounds/sections travelled and how I managed the healing. I have my next post op in mid October, so I’ll do another update then. I have a date booked for stage 3 for early next year, but at the moment it isn’t confirmed so I’ll find out at my post op if we are all good to go ahead then, so fingers crossed 🤞
At this point, I would say my glans is fully healed. I am very happy with the shape and how it looks, it looks better than I could imagine. The scar underneath the corona looks just like a circumcision scar, which has made me feel a lot better about the general look of my penis. So far it hasn’t flattened, but I am going to keep an eye on it. As for the progression of healing, it changed quite a bit. For the first week and a half it was pretty uneventful, and I just had combine dressings on it to keep everything in place. Eventually the glans started to bleed and ooze quite a bit and so I was having to change it more frequently, so I started using gauze on my glans, wrapping it around the incisions and taping it in place. I would change this every day, and use saline-soaked gauze on the wound for about 15 minutes every morning before redressing it to keep it clean as per Goossen’s recommendation. It was pretty sloughy and gross for about 3 weeks, but started settling around the 4 week mark. Eventually I didn’t need gauze anymore and it looked pretty much healed. I occasionally use a little bit of fixomul on the glans, two strips on either side to hold it back so it heals raised, but I stopped doing that as I didn’t really like having to take it off and at this point it doesn’t look necessary. I had a little area that took a little longer to heal, and that formed a bit of a scab. I just left it be and eventually it fell off. This has left s little divot in my glans, but it’s pretty subtle and not really noticeable. I’m super super happy with how it all looks, aesthetically it looks better than I could have dreamed!
SCROTUM AND VAGINECTOMY SITE
I’ll start with my vaginectomy site, which has honestly been the easiest part of recovery. I’ve had no issues at all with the healing of this, it all healed well and all the stitches dissolved no problem. The amount of relief this has given has been huge for me, knowing it’s gone makes me feel so much more at peace. Nothing really to say though as it was pretty uneventful and healed as well as one could hope, with no complications or issues.
My scrotum has taken its time to heal, and this has been the longest process of the whole surgery. Because of the shape of the wound, it’s very hard to actually manage, as you can’t really stick things in place or anything. I had quite a bit of ooze coming from a small hole behind my scrotum, which I just used some gauze on and changed when needed. I also had some ooze coming from the seam line where my scrotum joins in the middle, which I also used gauze for. I would salt bath both wounds for 15-20 minutes a day after my shower and I definitely think that helped. By week 5 most of the ooze was gone, and I felt a lot more comfortable. The hole behind my scrotum is now completely gone, and the seamline looks normal.
The look of my scrotum isn’t pretty, and honestly it looks a little strange without any implants. It’s kinda shrivelled and deflated, but I know implants will improve its look significantly. The right side is quite a bit larger than the left, as the left had some tissue removed in stage 1, but over time this has settled and it looks a lot more even now. I think it’s important to mention this because there is very minimal info regarding the actual scrotoplasty aspect of phallo.
Right after surgery, the scrotum was looking pretty small and Goossen was concerned about me potentially needing tissue expanders to create enough room to accommodate the implant and pump- but since healing I think it has actually descended rather than retracted as we expected. The scrotum looks quite a bit larger now since I last saw him, and I think shouldn’t pose an issue for implants, but I’m not a surgeon so we shall see in October. I’m crossing my fingers that we will be okay to go ahead with stage 3 as planned, as if I need another op before stage 3 it would throw out my timing quite significantly...so we shall see. If it needs to be done it needs to be done, but I’m hoping that it will be fine to proceed without them.
The part I was most concerned about of this whole surgery experience was no doubt my urethral lengthening- as this is where most complications typically stem from. I have been super lucky, and haven’t had any issues from the day I could stand to pee. Having the catheter was irritating, but it was so worth it for this result. I am so much more comfortable now and because of this, I’m drinking so much more water! I used to avoid drinking so I wouldn’t have to go to the bathroom because having to think about what I had in my pants stressed me out. Now that that’s not an issue I’m so hydrated. It’s great. I’m still stressing that something is going to go wrong, but there is no reason to. My stream is super strong and nice and straight and hasn’t changed at all. I don’t feel pain or irritation which is good, but the fear is still there and probably will still be there until I’m further down the line.
The sensation of peeing is weird. I can feel it in my natal urethra, and then it going through the bend where the new urethra and my natal urethra join, and then nothing. Because of this, it took a long time for me to not feel like I was just going to pee on the floor as it feels like it is exiting where it used to. I also was quite paranoid I was leaking because of this, even though I had no fistula or any reason to be stressed about it. This took a few weeks to get used to but wasn’t really something I saw discussed pre op. I can feel the urine through my urethra when I hold my penis as it makes it feel stiffer which is super cool.
My number one tip for if you’re having a catheter or just in general for this stage is to drink. Drink as much as you can and then drink more- it helped with the bladder spasms, it helped with the pain and with a catheter especially it’s important to keep things dilute. I had my 2L bottle with me that I took everywhere and I made sure to drink at least that entire thing every day and it made a huge difference, as once I forgot and the bladder pains and stinging was a lot worse. Drinking so much water during my recovery really got me into the habit and I’m really glad about it as it was definitely something I didn’t do as much as I should, and I feel better for it.
I had a bit of issue with post void dripping for a few weeks, and I combatted this by using a bit of gauze or toilet paper on the end of my penis to catch any remaining drips. I noticed this improved heaps at 5 weeks post op, as a lot of the swelling went down and it is easier to milk the urethra. I haven't had any issues with dripping since then really, which is good as it was getting kind of frustrating.
My incision from where the full thickness graft was taken for my glansplasty is healing well. Pretty uneventful. I put fixomul on it when I can be bothered, but due to its location it doesn’t seem to stretch much anyway and so this may be overkill. My SPC site is closed over, but at this stage is still kinda scabby. I’m just letting it be, it’ll heal in time. Pics of both are attached.
Since stage 2 I’ve noticed an increase in hair growth on my penis, probably due to the increased blood flow to the area. Although it’s a lot better since my electrolysis, this is still super disappointing. Part of me wants to wait until after stage 3 to continue with it as I’m not too keen to put all the time and money into it just to have it all grow back again. For the time being I’m just trimming it and I’ll make more of a decision later.
As I’ve mentioned, I had burial of my original genitals this stage- and since this sexually I feel a lot more comfortable. I am able to tell where it is located at the base of my penis, but honestly I don’t need to find it as just using my penis is enough. I haven’t lost the ability to orgasm, nothing really feels different in terms of the feeling compared to pre burial, just that now I’m not super dysphoric after. That’s all I’ll say about that as it’s pretty personal, but we are all good in that department lol.
Emotionally I feel great, being able to stand to pee has been huge for my dysphoria and I feel awesome about it. I’ve used urinals without issue, and it’s so nice not stressing about an STP failing or there not being any stalls. I also feel a lot more comfortable now that the vaginectomy is done as I still had a lot of dysphoria relating to those parts, so it feels like a weight has been lifted off me. As much as the first few days were awful, recovery for this stage has been a lot less stressful and I’ve been able to bounce back pretty quickly. I’m looking forward to my final stage and for this chapter to be over.
As always, let me know if you have any questions, my inbox is always open as well if you want to ask something privately. Hope the past few weeks have been treating you all well!
