Gender Reassignment Surgery
Male to Female

The surgical correction of the external genitalia in gender dysmorphic patients.

PRE-OPERATIVE
Suitability
- Must have Pyschiatric assessment over 2 years.
-Have a persistent wish over 2 years to change gender.
-Demonstrate ability to live in chosen gender role over 1 year.
Smoking
- Essential to stop at least 3 weeks before surgery and until the wounds are fully healed or at least 2 weeks after.
Drugs
- Stop oestrogen medication 6 weeks pre-operatively.
-Avoid aspirin and similar drugs for 2 weeks pre-operatively.
Bowel Prep
- Start preparation day before surgery. No fibre in diet for 5 days Begin bowel preparation as instructed.

OPERATION
Anaesthetic - General + epidural
Scars - Along border of new labia and around urethra.
Sutures - Dissolving buried.
Catheter - Bladder for 7 days.
Drains - Remain in place until 2nd post-op day.
Pack - Remains in place for 5 days.
Dressings - Intact for 2 days.

POST-OPERATIVE
Bed rest - Strict bed rest for 5 days.
Diet - Light diet until day 5.
Pack - Removed on day 5 post –op.
Catheter - Removed day 7 post-op.
Dilatation - Begin on day 5.
Discharge - Day 8.

POTENTIAL PROBLEMS
Pain - Moderate discomfort can be expected.
Avoid aspirin/ibuprofen type analgesics.
Bruising - May last for several weeks, and general post-operative swelling
may last for several months. Arnica will help reduce bruising and
swelling.
Wound - Occasional mild infection , invariably responds to a short course
of antibiotics.
- Rarely, delayed healing, skin loss or poor scars requiring revision.
- Very rarely, serious infection or haematoma (blood collection)
requiring drainage.
DVT - Leg vein thrombosis is rare. Measures will be taken to keep risk low.
Urinary retention - May occur on catheter removal. Will require re-catheterisation.
Late - Urethral stenosis will require surgery- meatotomy
- Bulb dilatation - can be reduced by surgery
- Poor scarring - can be improved by revision
- Prolapse uncommon – revision surgery.

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