2 Months Post Stage 2 RFF Phalloplasty

Apologies for the delay. My excuse – life.I’m at a strange point where I feel like I still have a ways to go in order to be fully healed from this stage, but at the same time stage three doesn’t feel like it’s very far away at all. 

I’ve started back on full days at work this week. It’s exhausting, but it’s nice to be out of the house and feel like I’m actually doing something. I’m going to see a trainer in the next couple of weeks to see about starting to get back into shape properly. My aim is to change jobs in the next year or so, and I need to be as fit as I can be to ensure that happens.

I’m no longer taking any pain medication. If I’m honest, I could’ve stopped taking everything the same day the catheter was removed, but I wanted to step down. I probably should be taking some still (I’ll go into why in the voiding section), but I want to keep an eye on the levels.

Movement

I am so much more comfortable since having the catheter removed! All I can think is that it was sitting awkwardly in my bladder and that was starting to irritate me. I’m also getting quicker and quicker in my movements, but I think that’s just going to take some time. The other day the wife and I went to the driving range to see how I went with golf, and I was presently surprised to see that I had no issues at all (except for being terrible at golf)!

Im still a little uncomfortable when sitting on hard surfaces, but lets face it – it’s only been two months since major changes were made to my body, I thinks it’s entitled to be a little sore!

Full Thickness Skin Graft (FTSG) Site

I’ve completely stopped using tape on the scar, and I’m now solely using silicon. It seems to be doing the job, the scar seems lighter and isn’t irritated anymore – which makes the whole thing more comfortable. Pictures below, comparing a couple of weeks ago to now. 

 Today

Phallus

He’s pretty much fully healed and all swelling has gone down. I’m using the silicon on my glansplasty site too, which is helping the appearance. The graft seems to have taken quite well, and the scar is flattening out nicely.

Scrotum/Perineum

No real change here at all. The swelling has completely gone down, and everything is just bobbing along nicely. Hans mentioned that he may do a mons resection as a part of stage three, but we’ll see how things go. I can definitely see why, the phallus is hanging a bit low, and the scrotum currently sits between my legs. I’m hoping to have lost a bit more weight by the time I see him again so that we can see if I actually need the resection or if it’s just thigh fat.

Voiding

*sigh* I wish I could say that I’m 100% happy, but I’m not. Don’t get me wrong, I love the way I’m urinating now; but it’s not exactly how I’d hoped things would be right now. 

I’m getting quite a bit of pain whilst urinating. It’s in my pubic area, and it’s… it makes my eyes water in its intensity, but it dulls after a bit. I find it’s worse when I’m a bit dehydrated, so I’m stuck in these two vicious cycles:

1. Not wanting to pee – so I don’t drink as much, get dehydrated, eventually pee and have a lot of pain; or

2. Drink a lot to stay hydrated, pee a lot more – so I’m in pain more often, but it’s a duller pain.

My GP has run urine tests to see if I have a UTI, so we’ll see what those results show. Currently I’m just keeping an eye on the pain. (Edit: tests came back negative for UTI, but showed high levels of pus and blood cells – which can be common after having a catheter in for an extended period of time. I’m redoing the tests to make sure the levels are going down)

Stream-wise, I’m a bit disappointed as well. The scarring at the tip of my phallus appears to cause somewhat of a buildup of urine, which has a few effects:

1. My stream is quite small because only a certain amount can push through at once,

2. I pee at about a 45 degree angle (which doesn’t bother me if I’m honest, it’s easy enough to rectify),

3. Once I finish peeing, I dribble quite a bit for a good half hour or so afterwards, because it just builds up behind the scar tissue and comes through in drops.

I can minimise the effects of the last one, with a combination of shaking, pressing just above my scrotum, and doing a little half-squat that seems to open up the scarring at just enough of an angle to let a fair bit pass… However the end result is that I have to wear a liner in my underwear. I know that dribbling isn’t uncommon – but the amounts are such that if I didn’t wear something, I’d stink of urine – which is just unpleasant. Ive put a picture below, showing basically what I mean – obviously it’s not to scale…

I’m going to have a chat to Hans about it when I see him in June, but I may need a revision done on the tip to remove some of the scarring. This isn’t preferable, but it may need to occur.
Below are a couple pictures of the healing from my SPC site. It’s healed pretty well, although it is indented slightly. 

Day after SPC was removed

After 1 week

Today

I think I’m at the stage where I’m happy to go back to monthly updates. Thankfully things have calmed down much quicker than they did with Stage 1, and overall so far I’m very happy with my results.

8 Months Post Stage 1 RFF Phalloplasty

Arm
I’m back into my scar care properly this month. At night, I wear a compression garment lined with silicon. During the day, I wear my normal compression garment, and alternate that with not wearing anything on the arm. Scarring is getting there slowly but surely, but it’s definitely a work in progress.
I’m also continuing using the vitamin E oils and moisturiser. Feeling is coming back very slowly but surely. 

Pictures are below, comparing last month and this month – it looks like things are a bit redder this month, but the scar is significantly flatter than last month.

Phallus
Continuing to heal well. The scarring on the tip seems to have stayed open, and things are gaining sensation slowly but surely.
At this stage I think doing updates for Stage 1 are pretty pointless. I’m going to roll my updates into the stage 2 one from now on.

Catheter Review #3

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Well, I’m back at the Gastroentanology area this morning to hopefully get this catheter out. Im torn between being nervous that something else is going wrong, and not really caring – it’s a complicated state of being, lol. From what I can pick up from speaking to Hans, the plan is for him to have a look at everything; and then hopefully take down the catheter. What that looks like at this point in time – I have no idea.

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One of the nurses just took me through the the rooms to do an initial set of obs and give me a little hospital bracelet. She’s going to call Hans and see where he’s at. He doesn’t normally start surgery until just after 8 – so hopefully things won’t be too long. 

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Just saw Hans. He’s happy with the way everything is healing so far – so we move on to the trail void. Basically the nurses are going to clamp off my SPC. I’ll then try to urinate into a bottle, and they’ll make sure I’m emptying my bladder enough. If they’re happy – my catheter comes out!

Hans also said that if I get home and start having issues, the best course of action is just to place a new SPC.

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I’m a leg bag down! Just the trial void to go. The plan is to give me a jug of water to drink within an hour (should be easy enough). Then I’ll wait until I get the urge to pee and go in a bottle. One of the nurses will then measure it and they’ll check my bladder to see if there’s any leaking internally or if I’m withholding urine. Apparently the fact that I’ve voided at home is a good thing, although the pain could still signify a hole.

I’ve asked if I can have a flip-flow valve if I can’t get the catheter out today… it works like a tap, so you can train your bladder to “search” for the need-to-pee feeling… but also means I don’t need to lug around a sodding leg bag.

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Looks like I’ll soon be catheter-less!

I’m still getting some pain when I pee, but it’s not too bad, and Hans is happy for the catheter to still come out. The nurses had me drink a litre of water and then I’d pee it out, get it measured and have my bladder scanned to see if I’m withholding. I’m averaging 150ml per void and I’m ending up with about 40ml leftover – which they’re happy with.

I’ve had an intramuscular antibiotic in my thigh to help avoid infection from the site once the catheter is removed, and the plan is to keep me here for a bit once it comes out so that they can see if I’m leaking. 

Apparently SPC sites can leak quite a bit initially when the catheter is taken out. 

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I have no catheter!

The worst part about the whole removal was the fact that I had a stitch knot embedded in the granulation tissue, which was very unpleasant the remove. 

Then the leaking started. I had been to the loo not long before, but when the catheter came out, so did a fair bit of urine. I managed to wet through two combines and a bluey; I now have two combines stuck to me and a massive nappy/pad. When they say it can leak a lot – believe them! It can take anywhere from 20 minutes to a couple of hours for the bladder to seal again, and then a few days for the SPC hole in your abdomen to heal over.

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I’m back at my parent’s place and resting. I feel so much more comfortable already, and I’m so glad I’m finally tubeless. 

7 Weeks Post Stage 2 RFF Phalloplasty

A few days ago, I bypassed my catheter again. After some initial pain (unsure what that was caused by), I managed to continue to void. Even though my stream is a bit smaller than it used to be (not sure if that’s because I was holding back or if I was worried about injuring myself), it was a steady flow that was all going in the right direction! I have a minor spray happening when I first start voiding (because of the scarring inside the tip), but once I start – it stops.
I decided that was as good a time as any to give Hans an update – since I hadn’t spoken to him for a couple of weeks – and he came back and said everything was looking good for a takedown of the SPC. So! At the time of writing, I’m in Brisbane waiting for the nurses.
I started my trial of half days at work this week. Because of my Brisbane trip, I only did three days – but it was enough. Same as last time, I’m exhausted. It’s nice to be out of the house though. Work is really good about everything, and thankfully it doesn’t hurt to sit at my desk. 
I’ve been a bit concerned that my body is trying to reject my catheter again over the last few days. It’s feeling very uncomfortable, and what didn’t help was that I pulled on it in my sleep the other night. Hopefully it’s not there for much longer anyway.

Movement

I’m actually starting to be able to do things a bit quicker! It’s taken a long time, but I’m getting there. The discomfort I’ve started feeling again makes me think that a lot of the problems I’m having with movement are to do with the catheter making me feel uncomfortable.

Full Thickness Skin Graft (FTSG) Site

Still healing well, and I’m now using tape and silicon to assist in scar management.

I’m not quite at the point of massaging just yet, because the area is still a bit sensitive – but at least the redness and swelling has gone down from the opsite dressings that I had it on

Phallus

No real change here this week. Everything is continuing to heal and reduce in swelling. 

Movement is getting better too. The more I move him around, the less it feels like things are pulling.

Scrotum/Perineum

No real change here this week. Everything is continuing to heal and reduce in swelling.
The granulation tissue around my clitoris is still there, but finally looks like it’s starting to go away/die. I haven’t been able to use the Mepilex because I can’t keep it in place – so I’ve just been trying to lee the area as dry as possible.