You have two surgical sites: your penis and your mouth. Both need attention.

1. Removing the penile bandage

Your penis is wrapped in a bandage that must stay in place for 2 days.

• Removal: Take the bandage off 48 hours after surgery.

• How: Look for the arrow drawn on the bandage and peel in the direction of the arrow.

• Three layers — make sure all three come off:

  • Coban — the tan, self-adherent outer layer

  • Kling gauze — the soft white middle wrapping

  • Xeroform — the yellow, greasy layer against the skin

• Underneath you will find surgical glue over the incisions. Leave it alone; it falls off on its own in 2 to 4 weeks. The stitches underneath dissolve and do not need to be removed.

2. Catheter care and bladder spasms

You went home with a urinary catheter. Keep it secured to your leg at all times with the securement device provided, so it cannot be pulled.

• Ointment for comfort: 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 at the opening.

• 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.

3. Mouth care (buccal graft site)

Tissue was taken from the inside of your cheek. Expect soreness and swelling in your mouth.

• Diet: No restrictions on what you can eat or drink. That said, soft, bland food for the first 72 hours will be considerably more comfortable.

• Magic mouthwash: Mix equal parts (1:1:1) of diphenhydramine liquid (Benadryl), Maalox, and 2% viscous lidocaine.

  • Swish to coat the area, then spit it out. Do not swallow.

  • Use as often as every 2 hours as needed for pain.

4. 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.

5. Antibiotics — timing is critical

Do not start these antibiotics now. They are not for surgical recovery.

• When to start: One day before your scheduled catheter removal appointment.

• How long: 3 days total — the day before removal, the day of removal, and the day after.

6. 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.

7. Medications and bowel care

• 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.

8. Activity restrictions

• No sexual activity while the catheter is in place.

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

• Driving: Not while taking oxycodone. You may drive once you are off narcotics and can stomp on a brake pedal without hesitating.

When to call the office

Contact us immediately if you experience:

• The catheter stops draining urine completely

• Fever over 101.5°F

• Spreading redness, warmth, or pus from an incision

• Bright red blood soaking through dressings or dripping continuously

1. Incision care and hygiene

• Showering: You may shower with soap and water daily starting the day after surgery. Let the soapy water run over the incisions — do not scrub. Pat dry gently with a clean towel afterward.

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

• Surgical glue: Your incisions are covered with a specialized glue that will flake and fall off on its own in 2 to 4 weeks. Do not pick at it. The stitches underneath dissolve and do not need to be removed.

2. Catheter care and bladder spasms

You went home with a urinary catheter. Keep it secured to your leg at all times with the securement device provided, so it cannot be pulled.

• Ointment for comfort: 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 at the opening.

• 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.

3. 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.

4. Antibiotics — timing is critical

Do not start these antibiotics now. They are not for surgical recovery.

• When to start: One day before your scheduled catheter removal appointment.

• How long: 3 days total — the day before removal, the day of removal, and the day after.

5. 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.

6. Medications and bowel care

• 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.

7. Activity restrictions

• No sexual activity while the catheter is in place.

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

• Driving: Not while taking oxycodone. You may drive once you are off narcotics and can stomp on a brake pedal without hesitating.

When to call the office

Contact us immediately if you experience:

• The catheter stops draining urine completely

• Fever over 101.5°F

• Spreading redness, warmth, or pus from an incision

• Bright red blood soaking through dressings or dripping continuously

You have two surgical sites: your perineum and your mouth. Both need attention.

1. Incision care and hygiene

• Showering: You may shower with soap and water daily starting the day after surgery. Let the soapy water run over the incisions — do not scrub. Pat dry gently with a clean towel afterward.

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

• Surgical glue: Your incisions are covered with a specialized glue that will flake and fall off on its own in 2 to 4 weeks. Do not pick at it. The stitches underneath dissolve and do not need to be removed.

2. Catheter care and bladder spasms

You went home with a urinary catheter. Keep it secured to your leg at all times with the securement device provided, so it cannot be pulled.

• Ointment for comfort: 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 at the opening.

• 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.

3. Mouth care (buccal graft site)

Tissue was taken from the inside of your cheek. Expect soreness and swelling in your mouth.

• Diet: No restrictions on what you can eat or drink. That said, soft, bland food for the first 72 hours will be considerably more comfortable.

• Magic mouthwash: Mix equal parts (1:1:1) of diphenhydramine liquid (Benadryl), Maalox, and 2% viscous lidocaine.

  • Swish to coat the area, then spit it out. Do not swallow.

  • Use as often as every 2 hours as needed for pain.

4. 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.

5. Antibiotics — timing is critical

Do not start these antibiotics now. They are not for surgical recovery.

• When to start: One day before your scheduled catheter removal appointment.

• How long: 3 days total — the day before removal, the day of removal, and the day after.

6. 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.

7. Medications and bowel care

• 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.

8. Activity restrictions

• No sexual activity while the catheter is in place.

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

• Driving: Not while taking oxycodone. You may drive once you are off narcotics and can stomp on a brake pedal without hesitating.

When to call the office

Contact us immediately if you experience:

• The catheter stops draining urine completely

• Fever over 101.5°F

• Spreading redness, warmth, or pus from an incision

• Bright red blood soaking through dressings or dripping continuously

1. Incision care and hygiene

• Showering: You may shower with soap and water daily starting the day after surgery. Let the soapy water run over the incisions — do not scrub. Pat dry gently with a clean towel afterward.

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

• Surgical glue: Your incisions are covered with a specialized glue that will flake and fall off on its own in 2 to 4 weeks. Do not pick at it. The stitches underneath dissolve and do not need to be removed.

2. Catheter care and bladder spasms

You went home with a urinary catheter. Keep it secured to your leg at all times with the securement device provided, so it cannot be pulled.

• Ointment for comfort: 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 at the opening.

• 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.

3. 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.

4. Antibiotics — timing is critical

Do not start these antibiotics now. They are not for surgical recovery.

• When to start: One day before your scheduled catheter removal appointment.

• How long: 3 days total — the day before removal, the day of removal, and the day after.

5. 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.

6. Medications and bowel care

• 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.

7. Activity restrictions

• No sexual activity while the catheter is in place.

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

• Driving: Not while taking oxycodone. You may drive once you are off narcotics and can stomp on a brake pedal without hesitating.

When to call the office

Contact us immediately if you experience:

• The catheter stops draining urine completely

• Fever over 101.5°F

• Spreading redness, warmth, or pus from an incision

• Bright red blood soaking through dressings or dripping continuously

This is a staged reconstruction. This first operation requires specific care for the graft on the penis — the bolster — and for the harvest site in your mouth.

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

A specialized dressing called a bolster is stitched to your penis. It applies pressure to the buccal graft so the graft heals into the tissue. Do not pull on it, trim it, or try to remove it.

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

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

• Showering counts. Letting water run over the bolster in the shower counts as one of your two daily wettings.

• A workable schedule: Shower in the morning (wetting #1), apply saline in the evening (wetting #2).

2. Incision care and hygiene

• Showering: Daily with soap and water starting the day after surgery. It is fine for soapy water to reach the bolster and the catheter. Do not scrub the surgical area — let the water run over it gently. Pat dry with a clean towel.

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

3. Catheter care and bladder spasms

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

• Ointment: If the area is reachable and not covered by the bolster, apply bacitracin ointment where the catheter enters the body to reduce irritation.

• Bladder spasms: It is common to feel a sudden strong urge to urinate or cramping pain in the bladder. This is the bladder reacting to the catheter.

  • 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 leg or night bag.

4. Mouth care (buccal graft site)

Tissue was taken from the inside of your cheek. Expect soreness and swelling in your mouth.

• Diet: No restrictions on what you can eat or drink. That said, soft, bland food for the first 72 hours will be considerably more comfortable.

• Magic mouthwash: Mix equal parts (1:1:1) of diphenhydramine liquid (Benadryl), Maalox, and 2% viscous lidocaine.

  • Swish to coat the area, then spit it out. Do not swallow.

  • Use as often as every 2 hours as needed for pain.

5. 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.

6. Antibiotics — timing is critical

Do not start these antibiotics now. They are not for surgical recovery.

• When to start: One day before your scheduled catheter and bolster removal appointment.

• How long: 3 days total — the day before removal, the day of removal, and the day after.

7. Scrotal support and swelling

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

• Ice: Apply an ice pack or a bag of frozen peas to the groin and 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

• 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.

• Driving: Not while taking oxycodone. You may drive once you are off narcotics and can stomp on a brake pedal without hesitating.

When to call the office

Contact us immediately if you experience:

• The catheter stops draining urine completely

• Fever over 101.5°F

• Spreading redness, significant warmth, or pus from the incisions or the bolster

This operation closed the urethra. You have two separate tubes and a bandage that needs careful management. Understanding the difference between the two tubes matters.

1. Removing the penile bandage

Your penis is wrapped in a bandage that must stay in place for 3 days.

• Removal: Take the bandage off 72 hours after surgery.

• How: Look for the arrow drawn on the bandage and peel in the direction of the arrow.

• Three layers — make sure all three come off:

  • Coban — the tan, self-adherent outer layer

  • Kling gauze — the soft white middle wrapping

  • Xeroform — the yellow, greasy layer against the skin

• Underneath you will find surgical glue over the incisions. Leave it alone; it falls off on its own in 2 to 4 weeks. The stitches underneath dissolve and do not need to be removed.

2. Your two tubes — they do different things

• Suprapubic catheter (from your abdomen). This is the tube that drains your urine.

  • Keep it secured to your body so it cannot be pulled.

  • Empty the bag regularly.

• Urethral stent (from the penis). A small tube at the tip of the penis.

  • This is a scaffold, not a drain. It holds the shape of the urethra while it heals.

  • It will not drain urine. Do not be alarmed that nothing comes out of it.

  • Do not pull on it or manipulate it.

  • Ointment: Apply bacitracin to the tip of the penis where the stent enters, twice daily, to reduce irritation.

3. Bladder spasms

Even though your draining catheter is in your abdomen, you can still get bladder spasms — sudden strong urges to urinate, or cramping pain.

• Prevention: Take oxybutynin 10 mg XL once daily.

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

• Leaking: Some urine or blood-tinged fluid around the urethral stent during a spasm is acceptable, as long as the suprapubic tube is draining well.

4. Hygiene and showering

• Days 1–3, bandage on: You may sponge bathe or shower, but the penile bandage must stay completely dry.

• Day 3 onward, bandage off: Shower normally. Let soapy water run over the incisions — do not scrub. Pat dry gently with a clean towel.

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

5. 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.

6. Antibiotics — timing is critical

Do not start these antibiotics now. They are not for surgical recovery.

• When to start: One day before your scheduled catheter removal appointment.

• How long: 3 days total — the day before removal, the day of removal, and the day after.

7. Scrotal support and swelling

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

• Ice: Apply an ice pack or a bag of frozen peas to the groin and 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

• 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 while the catheter and stent are in place.

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

• Driving: Not while taking oxycodone. You may drive once you are off narcotics and can stomp on a brake pedal without hesitating.

When to call the office

Contact us immediately if you experience:

• The suprapubic catheter stops draining urine completely

• Fever over 101.5°F

• Spreading redness, significant warmth, or pus from the incisions

• Bright red blood continuously soaking the dressing or dripping from the penis