Your operation used a skin graft. Care of the graft, the drains, and the donor site all matter to the result.

1. Bolster care — the most important thing you will do

A dressing called a bolster is stitched to your penis, applying pressure to the new skin graft so it heals into place.

• Do not remove it. Do not pull on it or trim it. Your surgeon removes it in clinic.

• Keep it moist. The graft's survival depends on it. Wet the bolster twice daily.

• How: Apply normal saline directly onto the bolster until it is damp.

• Showering counts as one of the two daily wettings. Shower in the morning, saline in the evening.

2. Your two surgical drains

• Recording output: Measure and record daily output from both drains. Bring the record to your follow-up appointment.

• Antibiotics: Because the drains are in, take the full 10-day course as prescribed.

• Removal: Removed in clinic once output drops.

3. Thigh skin graft donor site

If the graft came from your thigh, the wound is covered by yellow gauze (Xeroform), a white pad (ABD pad), and an elastic bandage (ACE wrap).

• At 48 hours: Remove the ACE wrap and the white ABD pad.

• The yellow Xeroform stays. Do not peel it off. It acts as a scab, drying and lifting away on its own as the skin underneath heals.

• Trimming: As the edges lift and curl, you may trim the loose parts with clean scissors.

• Hygiene: Once the outer layers are off, it is fine to shower with soap and water over the area.

4. Catheter care and bladder spasms

You went home with a urinary catheter. Keep it secured to your leg to keep tension off the repair.

• Ointment: Apply bacitracin ointment to the tip of the penis where the catheter enters, twice daily. This lubricates the area so the catheter slides easily and reduces irritation.

• Bladder spasms: The catheter irritates the bladder, which can cause sudden strong urges to urinate or cramping pain. This is normal.

  • Prevention: Take oxybutynin 10 mg XL once daily.

  • If spasms continue: Take Levsin (hyoscyamine) 0.125 mg every 4 hours as needed.

• Leaking around the catheter: It is normal to see urine or blood-tinged fluid leak around the catheter during a spasm or a bowel movement, as long as urine is still draining into the bag.

5. Hygiene and showering

• Showering: Daily. Soap and water may run over the bolster, the drains, and — after 48 hours — the thigh donor site. Do not scrub the surgical areas. Pat dry gently.

• Baths: Do not sit in standing water — bath, pool, lake, or hot tub — for 2 weeks.

6. Pain management

Stay ahead of the pain rather than chasing it. For the first two weeks:

• Alternate ibuprofen and Tylenol (acetaminophen) every 3 hours while awake. Each medication works out to every 6 hours.

  • 9:00 AM — Ibuprofen

  • 12:00 PM — Tylenol

  • 3:00 PM — Ibuprofen

  • 6:00 PM — Tylenol

• These two medications do not interact and are safe to take on this schedule.

• Breakthrough pain only: If you were prescribed oxycodone, it is intended only for pain the ibuprofen and Tylenol schedule does not control. It is a narcotic. Do not drive while taking it.

7. Scrotal support and swelling

• Support: Wear tight-fitting underwear — supportive briefs — to support the scrotum and reduce swelling.

• Ice: Apply an ice pack or a bag of frozen peas to the scrotum. Never put ice directly against skin; put a thin towel in between. Apply for 30 minutes at a time, every 3 to 4 hours.

8. Medications and bowel care

• Antibiotics: Take the full 10-day course as prescribed, to prevent infection while the drains are in place.

• Blood thinners: You may restart all prescribed blood thinners 72 hours (3 days) after surgery, unless you were told otherwise.

• Preventing constipation: Pain medication and anesthesia cause constipation, and straining to have a bowel movement puts real pressure on your repair. Take the prescribed stool softener every day for as long as you are taking pain medication.

9. Activity restrictions

• No sexual activity for 6 weeks.

• Lifting: Nothing heavier than 10–15 lbs — about a gallon of milk — for 4 weeks.

• Movement: Avoid strenuous activity and wide straddling movements that pull on the thigh donor site or the groin incisions.

When to call the office

Contact us immediately if you experience:

• The catheter stops draining urine

• Fever over 101.5°F

• Spreading redness, foul smell, or pus — as distinct from normal drain fluid

• Bright red blood continuously soaking through dressings