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Metoidioplasty with Urethral Lengthening

Postoperative Instructions

  1. No Strenuous physical activity of any type during the first 6 weeks (No bending, pushing, pulling, lifting (greater than 20lbs) straining or excessive walking)
  2. Resume your regular diet as tolerated (see soft diet suggestions below)
  3. Avoid excessive alcohol intake
  4. No smoking for at least one month following surgery
  5. Use pain medications as needed for pain/discomfort and please take antibiotics as directed
  6. DO NOT pull or dislodge supra-pubic catheter.
  7. The dressing around the release will be removed at your first postoperative appointment. You can shower after this appointment.
  8. Swelling is completely normal, and the release and scrotum will often swell to 2-3 times in size after the compression dressing is removed at the first postoperative appointment. You can apply circumferential pressure in a downward motion to help with the swelling after the first week.
  9. Please follow the following directions for your suprapubic catheter:
    1. Empty urine bag that is attached to the catheter at least 3 times daily or when full.
    2. If the suprapubic catheter is not draining, it is most likely due to the positioning. The urine bag must be below the level of the bladder in order to drain. If the catheter is not draining into the bag, it may be clogged and can be flushed with 30 cc of sterile water. Please call the office if the catheter is not draining into the urine bag.


Suggested Supplies

  • Hand mirror
    • Allows the patient to view surgical area while changing dressings
  • Thick pillow or Medical donut
    • For comfort while sitting or travelling.
  • Ice packs or Bags of frozen vegetable
    • Moldable ice packs or bags of frozen vegetables provide temporary pain relief and decrease swelling.
  • Extra pairs of underwear
    • Most patients prefer underwear that is looser and seamless if possible. Tight underwear can be uncomfortable and rub against the newly exposed skin. Seams can also cause discomfort.
  • Sweat pants and loose jeans
    • For comfort and to accommodate the catheter with drainage bag and drain that will still be present postoperatively.
  • Cushiony cup or pad for inside your underwear
    • Past patients have purchased soft cups from Andrew Christian. A heavily padded cup from a bra will also suffice. As patients have transitioned to wearing tighter briefs postoperatively, this provided comfort.
  • Lap desk
    • This may allow you to accomplish tasks and serve as protection against dogs/pets/children on your lap.
  • Extra Strength Tylenol (Acetaminophen)
    • Transition to taking Tylenol after your pain medication for mild to moderate pain relief. Do not take Tylenol concurrently with your pain medication as the pain medication also contains acetaminophen and large amounts may cause liver damage.
  • Maxi Pads (super absorbent)
    • Absorb any drainage after dressings are removed.
  • Medical cloth tape
    • Used for a variety of reasons including but not limited to taping your dressings and taping your catheter/drainage bag/drain to your leg.



  • Resume your regular diet.
  • Lack of activity postoperatively and pain medications can contribute to constipation.
    • Stool Softener
    • Prune Juice
    • Miralax may be used in the event extra help is needed
    • Avoid Metamucil or other fiber drinks as they may contribute to more constipation during the period of reduced activity

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