Author Topic: Extreme dilation pain  (Read 1204 times)

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Offline Emma Landing

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Extreme dilation pain
« on: April 30, 2021, 07:41:54 pm »
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?
« Last Edit: May 01, 2021, 06:39:50 pm by Emma Landing »

Offline Lady Grey

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Re: Extreme dilation pain
« Reply #1 on: May 01, 2021, 12:05:35 am »
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?



post op

Offline tgirlamg

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Re: Extreme dilation pain
« Reply #2 on: May 01, 2021, 11:46:45 am »
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 🙋‍♀️💕🌻
“To be yourself in a world that is constantly trying to make you something else is the greatest accomplishment” ... Ralph Waldo Emerson 🌸

“The individual has always had to struggle from being overwhelmed by the tribe... But, no price is too high for the privilege of owning yourself” ... Rudyard Kipling 🌸

Let go of the things that no longer serve you... Let go of the pretense of the false persona, it is not you... Let go of the armor that you have worn for a lifetime, to serve the expectations of others and, to protect the woman inside... She needs protection no longer.... She is tired of hiding and more courageous than you know... Let her prove that to you....Let her step out of the dark and feel the light upon her face.... amg🌸
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Offline Emma Landing

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Re: Extreme dilation pain
« Reply #3 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!

Offline tgirlamg

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Re: Extreme dilation pain
« Reply #4 on: May 01, 2021, 10:10:39 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!

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 🙋‍♀️💕🌻
“To be yourself in a world that is constantly trying to make you something else is the greatest accomplishment” ... Ralph Waldo Emerson 🌸

“The individual has always had to struggle from being overwhelmed by the tribe... But, no price is too high for the privilege of owning yourself” ... Rudyard Kipling 🌸

Let go of the things that no longer serve you... Let go of the pretense of the false persona, it is not you... Let go of the armor that you have worn for a lifetime, to serve the expectations of others and, to protect the woman inside... She needs protection no longer.... She is tired of hiding and more courageous than you know... Let her prove that to you....Let her step out of the dark and feel the light upon her face.... amg🌸
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Offline Lady Grey

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Re: Extreme dilation pain
« Reply #5 on: May 01, 2021, 10:39:38 pm »
Have you asked what size dilator they used for the graft?

post op

Online Rachel

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Re: Extreme dilation pain
« Reply #6 on: May 02, 2021, 08:32:42 am »
Hi, my graph died about 50%. At the 4 week mark dilation became painful. It became an extreme pain and would bring me to tears. I continued to dilate 30 minutes 5 times a day with 1-4 dilators. I had to have an operation to remove the scar tissue. I lost depth due to the operation. I was 3.5 inched deep post the second operation.

I had 13 doctor visits for granulation. I was shown how to apply the silver nitrite sticks on the 13th visit and continues to treat the granulation.

I had a third operation for fat injection and labia plumping. Think a balloon of fat in and around the vagina. It reabsorbed about 75% and looks much better.

When my graph died it turned a yellow color and surrounded the vaginal canal and went inside about 2.5 inches, maybe 3 inches. When it healed it was scar tissue and it contracted. The pain was a 10 out of 10.

I kept dilating. If I was to do it again I would sue super numb on the dilator to numb the area. The scar tissue had to be removed.

I was going to get peritoneal GCS due to the depth issue. I was instructed by RBL to get a doctor the demonstrate pelvic floor  exercises to increase depth. I did and it was my primary care doctor. They see thousands of trans. I then thought that a sybian would do the exercises for me. It did and I had orgasms too. My depth is between the 5th dot and horizontal slit with my labia at the slit. I was fully healed when I did this. I used motor bunny xl toys on the sybian.

I did not need another GCS operation and I am very happy with my depth. I have been with a lot of guys and do not have a depth issue.

This was my experience,
Rachel



 



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Dr. McGinn vaginal revision 2 4-3-2019 Bottom of vagina closed off, fat injected into the labia and urethra repositioned.
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Dr. Thomas laser vocal procedure 2/17/2021

Offline Emma Landing

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Re: Extreme dilation pain
« Reply #7 on: May 02, 2021, 02:15:53 pm »
tgirlamg, that sounds awful - I’m glad it healed up well. My surgeon did the silver nitrate when I saw them at 6 week mark, and then more recently sent me applicators for me to do myself, which I’m doing once a week. It helped initially, but frankly, there’s more blood now then there was before. I have a feeling this specialist I’m seeing tomorrow will do another round of the silver-nitrate.

Lady Grey, I’m not sure about the terminology, but when I asked how large they made the “opening” during surgery, they said that they test it with a 1 1/4” dilator.

Rachel, OMG, I’m so sorry you went through that. Thank you for sharing. I’ve previously read a few of your abbreviated posts about dilator depth, but I didn’t realize the full extent and the pain involved. That’s just terrible. I don’t think a lot of people understand the level of pain when they haven’t experienced it. It’s break-down sobbing levels of pain. It can be excruciating, and not just for 5 seconds, it can last the entire dilation session, and then leave you sore and barely able to move afterward for hours. It can break you. I’m so glad you made it through. So, the million dollar question - are you pain-free now during dilation?

(p.s. I just realized I started this thread in the "wrong" subforum - there's so many I got lost)

Offline tgirlamg

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Re: Extreme dilation pain
« Reply #8 on: May 03, 2021, 03:21:21 pm »
tgirlamg, that sounds awful - I’m glad it healed up well. My surgeon did the silver nitrate when I saw them at 6 week mark, and then more recently sent me applicators for me to do myself, which I’m doing once a week. It helped initially, but frankly, there’s more blood now then there was before. I have a feeling this specialist I’m seeing tomorrow will do another round of the silver-nitrate

Emma!… I didn’t consider it awful really... just part of an amazing ride!

I am hoping things went well at the specialist’s today!!! 🙏😀💕

Hugs!!!

Ashley 🙋‍♀️🌻💕
“To be yourself in a world that is constantly trying to make you something else is the greatest accomplishment” ... Ralph Waldo Emerson 🌸

“The individual has always had to struggle from being overwhelmed by the tribe... But, no price is too high for the privilege of owning yourself” ... Rudyard Kipling 🌸

Let go of the things that no longer serve you... Let go of the pretense of the false persona, it is not you... Let go of the armor that you have worn for a lifetime, to serve the expectations of others and, to protect the woman inside... She needs protection no longer.... She is tired of hiding and more courageous than you know... Let her prove that to you....Let her step out of the dark and feel the light upon her face.... amg🌸
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Online Rachel

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Re: Extreme dilation pain
« Reply #9 on: May 03, 2021, 05:09:14 pm »
Hi, when I dilate I use a bit of force so it has some pain involved. There is no pain from inserting the dilators, just from forceful dynamic dilation motion in the back of the canal where the motion is directed. When I use the sabian I use a toy that is longer and a bit wider(than normal) than my canal. So there is some pain but that is to be expected when stretching width and depth.

If I was to dilate as I was taught with 3 pounds of pressure there is no pain.

If I am with a big guy there is some light pain and pleasure. If I am with an average sized guy there is no pain. An uncircumcised large guy enters and exits much easier on the vaginal canal than a circumcised guy and there is more a feeling of pleasure and less pain, if they are large.

I would do it all over again if I had to. I do think I would have been much better off with a tummy skin graph as I was told I would have. My potassium was wiped out in the operation and the operation was cut short. So the tummy graph was not done.
MTF in need of help link https://www.susans.org/forums/index.php/topic,133631.1980.html
MTF in need of help 2 link https://www.susans.org/forums/index.php/topic,251825.0.html
HRT  5-28-2013
FT   11-13-2015
FFS   9-16-2016 -Spiegel
GCS 11-15-2016 - McGinn
Hair Grafts 3-20-2017 - Cooley
Voice therapy start 3-2017 - Reene Blaker
Labiaplasty 5-15-2017 - McGinn
BA 7-12-2017 - McGinn
Hair grafts 9-25-2017 Dr.Cooley
Sataloff Cricothyroid subluxation and trachea shave12-11-2017
Dr. McGinn labiaplasty, hood repair, scar removal, graph repair and bottom of  vagina finished. urethra repositioned. 4-4-2018
Dr. Sataloff Glottoplasty 5-14-2018
Dr. McGinn vaginal in office procedure 10-22-2018
Dr. McGinn vaginal revision 2 4-3-2019 Bottom of vagina closed off, fat injected into the labia and urethra repositioned.
Dr. Thomas FemLar 10/13/2020
Dr. Thomas laser vocal procedure 2/17/2021

Offline Emma Landing

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Re: Extreme dilation pain
« Reply #10 on: May 05, 2021, 12:34:43 am »
Thanks Rachel for sharing that!

Thanks Tgirlamg for the well wishes. I saw him yesterday, and he seemed like a really good doctor and consults regularly with my surgeon (who is in another state). There wasn't much he could do for the pain, nor offer an explanation for why I'm having so much pain during dilation, but he suggested going down a dilator size which will offer some temporary relief and hopefull things will continue to heal. He also said it was safe to start some basic stretching exercises. He did a speculum exam, which didn't hurt at all - that was curious. He did another treatment of silver-nitrate getting to some internal spots I couldn't do myself. I'll see him again in two weeks.

I was a little freaked out yesterday after the appointment, as there was more blood than I had ever seen before - like it quadrupled from what was already my bloodiest day. That continued til this morning. But then I had my best day today physically - the closest I've ever felt to "normal" post-surgery. Dilating with a smaller size was a huge relief. The constant throbbing pain (of varying degrees) that's been at the surgical site for 3 months magically dissipated for the last 12 hours. I know from experience that it often takes a step back before moving forward again, so I'll just have to hope things turn a corner.

Best wishes!

Offline tgirlamg

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Re: Extreme dilation pain
« Reply #11 on: May 05, 2021, 01:04:20 am »
Emma!!!

Awesomeness!!! 😀 It sounds like things are moving in the right direction!!! ... That’s so good to hear! I think everyone has a bit different experience with the healing process... continued good healing to you sister!…all this will be in your rear view mirror before you know it... The healing process always provides endless opportunities for stress and worries but in the end... all is well and you will be back to living life with lots of opportunity to worry about other stuff!!! 😅 Lol

Onward we go brave sister!!!

Ashley 🙋‍♀️💕🌻
“To be yourself in a world that is constantly trying to make you something else is the greatest accomplishment” ... Ralph Waldo Emerson 🌸

“The individual has always had to struggle from being overwhelmed by the tribe... But, no price is too high for the privilege of owning yourself” ... Rudyard Kipling 🌸

Let go of the things that no longer serve you... Let go of the pretense of the false persona, it is not you... Let go of the armor that you have worn for a lifetime, to serve the expectations of others and, to protect the woman inside... She needs protection no longer.... She is tired of hiding and more courageous than you know... Let her prove that to you....Let her step out of the dark and feel the light upon her face.... amg🌸
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Offline mariah

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Re: Extreme dilation pain
« Reply #12 on: May 10, 2021, 11:35:26 pm »
Sounds like they need to take another look. I also had to deal with granulation and lost a little bit of depth temporarily due to the granulation. One thing that I learned rather early on is no matter what schedule the surgeons set out when we got surgery. Our bodies end up dictating the schedule in the end. In my case that was slowed down due to the granulation which can lead to bleeding which I dealt with until I fully healed. So sorry your going through the pain every time you try to dilate. The going down a size would have been my recommendation as well which is something I had to do a bit before going back up myself. It could really help with the pain level while your needing to use silver nitrate. Hugs and Good Luck.
Mariah
tgirlamg, that sounds awful - I’m glad it healed up well. My surgeon did the silver nitrate when I saw them at 6 week mark, and then more recently sent me applicators for me to do myself, which I’m doing once a week. It helped initially, but frankly, there’s more blood now then there was before. I have a feeling this specialist I’m seeing tomorrow will do another round of the silver-nitrate.

Lady Grey, I’m not sure about the terminology, but when I asked how large they made the “opening” during surgery, they said that they test it with a 1 1/4” dilator.

Rachel, OMG, I’m so sorry you went through that. Thank you for sharing. I’ve previously read a few of your abbreviated posts about dilator depth, but I didn’t realize the full extent and the pain involved. That’s just terrible. I don’t think a lot of people understand the level of pain when they haven’t experienced it. It’s break-down sobbing levels of pain. It can be excruciating, and not just for 5 seconds, it can last the entire dilation session, and then leave you sore and barely able to move afterward for hours. It can break you. I’m so glad you made it through. So, the million dollar question - are you pain-free now during dilation?

(p.s. I just realized I started this thread in the "wrong" subforum - there's so many I got lost)
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Offline Emma Landing

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Re: Extreme dilation pain
« Reply #13 on: May 21, 2021, 11:12:01 am »
Haven't checked-in in a bit...

Thanks Mariah!

Since my last post, over the course of that week, things degraded and became increasingly difficult and painful again (and when I say that, I mean going from still painful to very painful)

I've saw a gynecologist last week and she did a full speculum exam. She checked the pelvic floor muscles with her fingers. I had mentioned that it felt like the dilator was hitting bone, and she said that wasn't possible, but when she first felt the muscles, she wasn't sure what she was feeling they were so rock-hard. They loosened up a bit after a minute, and she was reassured that it was just muscle tissue. We've scheduled a procedure in two weeks to surgically remove the granulation, if it hasn't healed enough by then. She finished the session with another silver nitrate treatment, with similar results as the last time - it was "better" for a couple days and then by the end of the week, I wasn't sure I could go on, there was so much pain.

I saw a pelvic floor physical therapist at the beginning of this week. She did internal deep tissue massage therapy, where she massaged the pelvic floor muscles with her fingers. She could immediately feel how hard they are. We did a 2 hour session, and at the end, I tried inserting my dilator and it still didn't want to go in. I have weekly sessions scheduled.

I also saw the urologist again this week. He indicated there had been healing progress in the the two weeks since last time. He did another silver nitrate treatment, with similar results, though the positive effects seem to be lasting just a little longer. He prescribed a muscle relaxant to see if that could diminish the muscle tension - I’m supposed to receive it today. I see him again next week.

I'm still in a lot of pain with no end in sight. The granulation, which I’ve had continuously for over 3 months, feels like second-degree burns. The pelvic floor muscles feel like a continuous charlie-horse while dilating, and radiate pain for hours afterward. The pain is eroding my mental and emotional stability. “Expectations” aside, this is torture - there’s only so much pain I can endure before I completely break. I can only hope things turn a corner very soon. I don’t need to be pain-free at this point, it just needs to get down to manageable levels. I’m fortunate to have a medical team on the case.

Thanks again for everyone's comments and words of support.

Offline RandiL

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Re: Extreme dilation pain
« Reply #14 on: May 21, 2021, 12:36:07 pm »
Emma, this muscular pain sounds so difficult! I'm so sorry you're going through this.

Is it possible there's an emotional block, perhaps fear or anxiety that's causing you to tense those muscles?

I hope this resolves soon. Hugs, Randi

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Offline tgirlamg

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Re: Extreme dilation pain
« Reply #15 on: May 22, 2021, 12:06:26 pm »
Emma!

What an ordeal sister!... I’m so sorry! ... I hope the procedure in two weeks, if needed, brings relief from the pain!... Hang in there girl 💕🙏💕Sending Good and Healing Thoughts your way!!!

Hugs!!!

Ashley 🙋‍♀️💕🌻
“To be yourself in a world that is constantly trying to make you something else is the greatest accomplishment” ... Ralph Waldo Emerson 🌸

“The individual has always had to struggle from being overwhelmed by the tribe... But, no price is too high for the privilege of owning yourself” ... Rudyard Kipling 🌸

Let go of the things that no longer serve you... Let go of the pretense of the false persona, it is not you... Let go of the armor that you have worn for a lifetime, to serve the expectations of others and, to protect the woman inside... She needs protection no longer.... She is tired of hiding and more courageous than you know... Let her prove that to you....Let her step out of the dark and feel the light upon her face.... amg🌸
https://www.susans.org/forums/index.php/topic,251753.60.html

Offline AnonyMs

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Re: Extreme dilation pain
« Reply #16 on: May 22, 2021, 12:19:32 pm »
Its not very common but over the years I’ve come across quite a few stories like this, and also met someone who had something similar.

Its unclear to me what is happening. Granulation that needs surgical removal is quite severe, most people with granulation don’t need that. Is it the sole problem/cause of pain?

Are you taking drugs to help with this? Strong painkillers can help a lot, assuming you can get them. If you have muscles tensing up then perhaps a benzo of some kind to help you relax, and possibly reduce the pain.

Some women use topical anaesthetic cream, EMLA for example, on the dilator, but it can interfere with healing. That phase should be over at 12 weeks, but I’m not sure if it an issue with granulation.

Offline Emma Landing

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Re: Extreme dilation pain
« Reply #17 on: June 01, 2021, 04:30:56 pm »
Hi all, thank you again for your replies and well wishes… when things become as dark as they’ve become at times, it really does help. It means a lot more to me than I would have thought. I’m hanging on by a thread.

Things have deteriorated further since my last post. A lot has happened and I may share some of that in a future update if it could be helpful to others, but I’m waiting to see the surgeon next week for an in-person diagnosis. Based on what’s been discussed, it’s pointing to surgery.

I’ll plan to provide an update after getting an official diagnosis.

Best wishes to everyone.

Offline OldSchool

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Re: Extreme dilation pain
« Reply #18 on: June 06, 2021, 07:56:16 am »
I was going to get peritoneal GCS due to the depth issue. I was instructed by RBL to get a doctor the demonstrate pelvic floor  exercises to increase depth. I did and it was my primary care doctor. They see thousands of trans. I then thought that a sybian would do the exercises for me. It did and I had orgasms too. My depth is between the 5th dot and horizontal slit with my labia at the slit. I was fully healed when I did this. I used motor bunny xl toys on the sybian.

I did not need another GCS operation and I am very happy with my depth. I have been with a lot of guys and do not have a depth issue.

This was my experience,
Rachel

Hi Rachel,

Can you tell me more about the depth you had, the depth you obtained, and how you did it? I lost depth several years after the operation and would like to regain it. I don't think I can PM yet, but if you could PM me I would be grateful.

Offline Lady Grey

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Re: Extreme dilation pain
« Reply #19 on: June 07, 2021, 10:31:15 pm »
Emma, I'm not sure this applies to you but I'll tell you anyway.  I had my surgery about 16 weeks ago and was troubled with a fissure on the roof of my vagina right at the graft. Also a smaller fissure right below it on the bottom of my vagina at the graft.  For the last couple of weeks I have been paying particular to the angle of penetration of my dilator/dildo.  I had the penile inversion method and I'm pretty sure the angle of entry for my vagina is different than the angle of entry for a cis woman's vagina. My transvagina sort of sits right where my perineum was so that it is now pretty much parallel to the ground when I am standing.  Keeping this in mind, now whenever I dilate I lay down on my back in bed and insert the dilator/dildo into my transvagina keeping it exactly parallel with the bed (about an inch off of the bed surface).  I used to be pulling up on it (towards me) when I inserted it and inserting it and holding it in at more of a 45 degree angle to my transvagina instead of a 90 degree angle, and this was putting undue stress at the site of both fissures.  Since I have started doing this the blood spotting has completely disappeared and the the bottom fissure is completely healed and the upper fissure, the worst of the 2, is almost healed and it's just so much of a nicer experience.   I was doing the silver nitrate but I'm not even sure I will need another treatment.  Don't know if this helps.  Hope your doing better. Get well soon. Thinking of you.
-Jane
post op

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