Community Conversation > Post operative life

Extreme dilation pain

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Emma Landing:
Hi community,

I’m 3 months post-op on vaginoplasty (typical penile-inversion, no grafts).

Dilation is still extremely painful. Not “uncomfortable”, or “momentarily hurts going in”, but rather torture-level of pain. Like, this can’t go on indefinitely - I’m breaking down from months of relentless pain.

I’m still currently dilating 3-4 times a day reaching a maximum of a 1.25” (32mm) dilator. These are literally hour long sessions with setup, warmup, dilation, and cleanup.

The whole experience is painful, but the most painful part is pushing through the pelvic floor muscles - it’s like hitting a brick wall. It generally takes about 30 minutes before I can get through with the max size dilator, starting with tapered and smaller dilators and working my way up. Even once I’m through, the muscles are like clamps biting down on the dilator, resulting in constant pain the entire time I’m dilating. The vaginal canal stings and just plain hurts.

Has anyone experienced this at 3 months, and if so, did it get better?

Lady Grey:
I'm almost at 12 weeks and I'm still on the 1 inch blue dilator.  I only do it three times a day for 15 minutes at a time.  In a few days (after 12 weeks) I will only be dilating twice a day for 15 minutes at a time  That's following the advice of my physical therapist.  I still have some discomfort - a small fissure that has not completely healed that only bothers me when I am penetrated and it's not too bad.  Once in a while I will see a little bit of pink on the dilator, but I haven't seen that for a few days now.  I do a Sitz bath for 15 minutes a day to promote healing.  I probably won't go up to the 1 1/4 green dilator until I'm completely healed.   My physical therapist assures me there is absolutely no need to rush it.  I'm not going to be a hero. 

FWIW if I were experiencing one hour of torture every time I dilated I would definitely consult with my medical team about going back to a smaller size dilator for awhile.

Are you doing deep breathing and relaxation techniques?



tgirlamg:
Emma!... Welcome to the forum and I am so sorry things are not going as smoothly as you woukd like!... I would start with your surgeon’s office and see what they advise... perhaps some slight revision may resolve things well for you! Sending good and healing thoughts your way sister!

Hugs!

Ashley 🙋‍♀️💕🌻

Emma Landing:
Thanks you both for your thoughts and well wishes, and Lady Grey, I hope you're fully healed soon.

I've been communicating with surgeon, saw them in person at 6 week mark (at that time, they said give it a few more weeks to heal), have consulted with a pelvic floor specialist, have tried all the general tips. I'm seeing gynecologist with experience in transgender care in a week.

I've followed surgeon's directions on dilator size and frequency. I started with a 1". Since I let them know about the pain situation within the first week, I previously inquired about the necessity to move up in size, which they implied was important to do on their schedule (I'm planning to bring it up again with them). They also had me go from 4 times a day to 2 times a day at the 4 week mark, which I did, but after things got increasingly difficult and losing depth, they suggested increasing frequency, which has barely helped and in some ways seems to be causing further inflammation.

I've also been suffering from severe skin dehiscence and granulation (lots of blood after every dilation... literally dripping blood), which isn't healing and is getting worse (I'm seeing another specialist about that in a few days). It appears that’s mostly at the perineum, but I can’t tell - it's possible it’s also within the vaginal canal, and that could be contributing to the pain and inflammation during dilation.

I've read lots of previous threads about general discomfort and tips for dilating, both pre and post surgery, but I've never heard or read anyone speak of such extreme pain during dilation that I’m experiencing. What I'm experiencing is definitely not in the realm of “normal”. I have a high threshold for pain. Again, not talking about "discomfort", I'm talking about "punched in the face". It's a wonder I've held on this long, but I don't know how much longer I can.

I know it's a long shot posting here, but I'm looking for anyone that has had a similar experience to mine or recalls someone posting similar that they can point to.

Best wishes!

tgirlamg:

--- Quote from: Emma Landing on May 01, 2021, 06:36:24 pm ---Thanks you both for your thoughts and well wishes, and Lady Grey, I hope you're fully healed soon.

I've been communicating with surgeon, saw them in person at 6 week mark (at that time, they said give it a few more weeks to heal), have consulted with a pelvic floor specialist, have tried all the general tips. I'm seeing gynecologist with experience in transgender care in a week.

I've followed surgeon's directions on dilator size and frequency. I started with a 1". Since I let them know about the pain situation within the first week, I previously inquired about the necessity to move up in size, which they implied was important to do on their schedule (I'm planning to bring it up again with them). They also had me go from 4 times a day to 2 times a day at the 4 week mark, which I did, but after things got increasingly difficult and losing depth, they suggested increasing frequency, which has barely helped and in some ways seems to be causing further inflammation.

I've also been suffering from severe skin dehiscence and granulation (lots of blood after every dilation... literally dripping blood), which isn't healing and is getting worse (I'm seeing another specialist about that in a few days). It appears that’s mostly at the perineum, but I can’t tell - it's possible it’s also within the vaginal canal, and that could be contributing to the pain and inflammation during dilation.

I've read lots of previous threads about general discomfort and tips for dilating, both pre and post surgery, but I've never heard or read anyone speak of such extreme pain during dilation that I’m experiencing. What I'm experiencing is definitely not in the realm of “normal”. I have a high threshold for pain. Again, not talking about "discomfort", I'm talking about "punched in the face". It's a wonder I've held on this long, but I don't know how much longer I can.

I know it's a long shot posting here, but I'm looking for anyone that has had a similar experience to mine or recalls someone posting similar that they can point to.

Best wishes!

--- End quote ---

Hey Again Emma!

I had a hemotoma and some bleeding complications but, everything resolved without additional intervention after the hemotoma was drained...I did have some dehiscence in the area of the hemotoma which blew out a couple stitches but, it had no real effect on the final result which was very good...bleeding from dialation became less and less each day... I know that granular tissue and bleeding can often be resolved pretty well with an in office procedure using silver nitrate…

All good things to you sister!

A 🙋‍♀️💕🌻

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