There are so many resources online for preparing for vulvovaginoplasty. We don’t expect to rewrite them or create one list to rule them all. Still, we did wish to make a hospital checklist for our patients getting ready for vulvovaginoplasty (or vaginoplasty without vulvoplasty!)
Background readings and videos:
- Our general guide to bottom surgery.
- Our detailed blog on vulvovaginoplasty.
- OHSU’s Vulvovaginoplasty patient booklet.
- Kaiser Permanente’s Vaginoplasty Surgery, Recovery, and Healing guide.
- Dr. Colt St. Amand’s video series on preparing for surgery and recovery.
- Dr. Ken McGee’s Physically Preparing for Bottom Surgery blog.
You will be in the hospital after surgery for several days and in bed for most of that time. Your care team will encourage you to get up and walk around as soon as it is safe, but you’ll be on bed rest at first to protect your early healing.
Planning for this time:
- You may sleep a lot, especially during the first few days. However, sleeping in hospitals can be rough!
- Consider bringing earplugs and an eye mask to reduce the noise and lights around you.
- On subsequent days, you may have a lot of time with not a lot to do:
- You’ll be encouraged to do physical therapy exercises every hour while you’re in bed.
- Bring activities that you can do when you are otherwise resting.
- Consider getting an art bin or small basket/box to organize your belongings on your bedside tray/table.
- Consider getting a charger with a long cord for your personal electronics.
- Food!
- You’ll be able to order food from the hospital cafeteria.
- Visitors can bring you food, too.
- Consider bringing a supply of your favorite snacks to have in your room.
- Comfort!
- Your care team will try to keep you as comfortable as possible, but you may also wish to bring items from home that will help you feel at ease:
- An extra blanket or your favorite pillow.
- Squishes, plushes, a blahaj to hug.
- Your favorite sweatshirt or sweater (consider a zip-front hoodie or cardigan!)
- Hospitals are notoriously cold and dry! Lotions, lip balm, your favorite self-care items. It may be a great time to bring cotton gloves/socks and heavy-duty moisturizer and deep treat your hands and feet (you might need some help to reach your feet!)
- Accessibility Tools!
- A reacher tool for those things that are too far away.
- A scratcher tool for your legs, feet, or back.
- Maybe even a lotion stick.
- A notebook or notepad and writing utensil(s) to write down questions, thoughts, and important information (or other communication devices as appropriate.)
- A hand-held mirror. Buy one bigger-than-you-think-you-want one so viewing is easier.
Do you have sensory needs, allergies, or chemical sensitivities? We’ve also written a guide for navigating a hospital stay with those!
When You Go Home After Surgery
You’ll have both activity restrictions (No heavy lifting! No saddle activities!) and new activities to do (Dilating! Douching!) once you’re home from the hospital. Our planning checklist also contains some of the items that will make your early recovery easier:
- A set of dilators, if not supplied by the hospital.
- Ice packs for swelling and pain.
- Extra undies that are roomy and can get stained. You’ll be swollen and may bleed or have other discharge. Check out disposable mesh undies for postpartum use – those sometimes have ice pack holders, too! Some companies, like Thinx, make washable postpartum undies.
- Maxi pads.
- Lots of lube! Your surgeon will likely recommend one, but you’ll want a water-based jelly lubricant like Surgilube or McKesson.
- Other medical/first aid supplies:
- Lots of gauze! 4” x 4”
- Bacitracin antibiotic ointment.
- Medical tape for dressings.
- Stool softeners.
- A thermometer to check for fevers.
- Distilled or purified water.
- Nausea meds.
- A hefty supply of toilet paper, paper towels, and personal or cleaning wipes or washcloths. Toileting may be messy for a while.
- Absorbent bed pads. These are available in disposable and washable forms and are often called “chux” pads.
- Extra bath towels. You’ll be encouraged to take showers frequently at first. Damp towels are a downer.
- A peri bottle. Peri is short for “perineal irrigation.” Peri bottles are available as a small regular squeeze bottle or with an angled nozzle so that you don’t have to contort too much to get the water where you want it to go. A (gentle) bidet in a bottle!
- A douche bottle and douching supplies (vinegar, soap, or your surgeon’s recommendation.)
- A donut pillow. You won’t be sitting much for a while, but a donut pillow can keep pressure off of tender tissues when you do. (Have your ride bring one for your ride home!)
- Not just your grandma’s blow up ring anymore! They’re available under multiple names (tailbone, coccyx, hemorrhoid, perineal, postpartum pillows/cushions,) materials (inflatable, foam, gel, memory foam,) and shapes (round, square, ergodynamic.) Some have ice packs!
- Clothing
- Comfy and loose!
- Consider zip-up or button-up tops to minimize upper body reaching.
- Consider skirts, dresses, or elastic-waist bottoms that allow easy access or pull on/off. If you ever needed an excuse for a kaftan or muumuu…
- Pre-prepped meals that are easy to reheat and eat.
- Accessibility supplies:
- Bring home your reacher/grabber, back scratcher, and lotion stick!
- Bendy straws.
- Hypoallergenic, unscented baby wipes.
- Roller cart to bring things from room to room.
Download our checklist:
Don’t Just Take Our Word For It
In a bit of perfect timing, an internet friend was in the first few days of recovery while we were researching this piece and agreed to answer a few questions. The usual disclaimer applies: Lena’s thoughts and insights are her own, and she does not represent QueerDoc. Lena’s comments have been lightly edited for length and flow.
Lena Chipman (she/her/hers) is an out and proud transgender woman, but also a successful technology executive, entrepreneur, activist, philanthropist, writer, and mom. A lifelong Memphian, she’s a voice for the voiceless, advocating for queer and particularly trans liberation by night even as by day she solves some of the most complex problems for some of the world’s largest companies. When she’s not out biking, speaking at rallies, or catching Pokemon with her daughter, she can be found on LinkedIn or on Instagram or Facebook as “lenaoflune”.
Do you have favorite sources for pre-op and post-op advice? What are they?
The best sources for information are going to be your surgical team, your gender-affirming care doctor (if they see many patients who’ve had this surgery — some haven’t), and other trans people you know who’ve had the surgery. If you’re just exploring and curious about what it can be like, a number of clinic websites can give you insights. (QD note – see “background readings” above). A number of trans women have also written about their experiences with the procedure online.
What was the most useful advice you received? What was the least helpful advice you received?
In retrospect, the most useful advice was to expect a long, difficult recovery and to lean on your support system during it. The complication rate of this surgery is fairly high, though most complications are minor. Personal tolerance for pain, emotional challenges, and the like will really determine the flow of your recovery, but in all cases it’s important to remember this is major pelvic surgery and you need to keep perspective — and good caregivers close.
The least helpful advice was the “lengthy list of things you need to make sure you have.” Really, while you’re in the hospital, you’ll be tired and hungry most of the time, as well as bored. The only things you need to have are something to amuse yourself when you’re not asleep, a big hand mirror for when they teach you how to dilate, and a sense of humor and grace over the situation.
What do you wish you:
- Had known beforehand
- Knowing how 5-7 days on bed rest affects me would have been extremely helpful. I’d had another general anesthesia surgery before, so I’m familiar with how much the first several hours out of surgery are deeply unpleasant, but I was wholly unprepared for the level of chaos that a week of strict bed rest causes. Go slow, call your nurses so you don’t fall, and take deep breaths. Being on your back for so long redistributes fluids and changes blood flow in a way that makes getting up a challenge to say the least.
- Had taken to the hospital with you
- A larger hand mirror for learning to dilate? Really, it’s what I wish I hadn’t taken. I didn’t need my laptop (no room for it) or several changes of clothes (you won’t want to put on clothes even when they let you), nor did I need a bunch of fancy soaps or a ton of entertainment options. I do wish I’d brought earplugs, though. Even without a monitor on me, and even with intentional choices to keep down sound levels at night, hospitals can be a bit loud.
- Had in your post-op recovery
- Panties. Lots of panties, and maxi pads with wings. I can’t stress enough how much you will be oozing from the sutures (even if you don’t suffer a significant wound separation like I did) and from your neovagina, and from the sites of your fluid drains once removed. I quite literally destroyed three pairs of panties in as many nights with oozing and leakage. Maxi pads help a lot with this, but don’t be surprised that you have go through a lot of panties. Puppy pee pads — the cheap version of Chucks pads — are also helpful.
Was there any particular accessibility tool that was very useful?
You will want one of those grabber arms, because you won’t be able to kneel, bend over, or squat for a while and nothing is more helpful for picking things up off a floor. I didn’t find canes or other mobility tools particularly helpful, though a stepstool to get into higher vehicles as needed is very useful.
And any other tidbits that may seem useful to share with others!
This surgery is a Big Deal. I don’t regret it, and I wouldn’t tell anyone not to have it or to second-guess themselves having it, but I would note that it comes with a lengthy recovery with a relatively high probability of unexpected things going wrong. Make sure you have a strong support system, a safe place to rest, and your therapist’s cell on speed dial.
Stay tuned for upcoming surgery checklists, and stay checked in with QueerDoc through our occasional emails:
