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Any pelvic physical therapy advice for dilation and groin pain at 8 mo post-op?

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Janna:
I had peritoneal pull-through vaginoplasty March of this year.  Healing was much slower than average but I'm in my 40s so I thought that was maybe normal.  Things were gradually improving but around 6 months I stopped improving and dilation started getting harder instead of easier and pain/swelling are often worse than previously.  So I'm trying to get an appointment for pelvic physical therapy but I wondered if anyone could suggest any types of exercises or techniques to use until I can get an appointment?

Thanks!

Rachel:
Hi, have you reviewed the situation with your surgeon?

My friend had penile inversion and then PPV to extend depth. She had it in March and orange is difficult. Sometime when she dilates there is blood. She has seen her surgeon several times and has an appointment with another surgeon for an opinion. She had surgery in March. She has sex but with average sized guys and no larger.

Janna:
Since I live 8+ hours from the surgeon, they can't do much to help in a video visit, nor can they refer me to a physical therapist without physically seeing me (and even then they seem reluctant to refer because they're a specialist instead of a general practitioner).  So I'm waiting to see a GP because the physical therapy place I'm trying to use said they need a referral.

So I'm just asking if anyone has general advice for exercises, stretches, or other things I can do while I wait to see the therapist.  I searched these forums but couldn't find anything.  Also found nothing specific to SRS on youtube or other places.

I did discover today that ice helps a lot when my pain flares up.  I thought I would be well beyond the time of swelling where ice would help but it still helps.

Rachel:
I has 3 operations and 2 procedures for GCS. I had some difficulties.

After the first operation, when my nerves reconnected I had an area that felt pain when pressure was applied. I would massage the area. At some point my vagina was done and the nerve pain went away. I think associating pleasure with the spot helped. Maybe the nerve just needed time to fully heal. I do not know. 

My girlfriend dilates 3 times a day and sometimes skips orange when there is blood from a previous dilation. She had PPV to increase her depth.

I had a consult with RBL due to 2 issues.  1) depth and 2) cosmetics on the lower outside of the vagina. RBL said I had to go to get pelvic floor instruction from a professional and do it 2 times a day.

I go to MAZZOIN and there are thousands of trans in the practice. My NPT-c showed me how to do
pelvic floor exercises. In about a week my hands hurt. It required a lot of force. I was fully healed. I used a sabian for depth and width and it worked very well. I was fully healed and you may not be fully healed. If you are swelling from dilation then I would consult with your surgeon.

Anyhow, I meet with RBL and my depth and diameter is fine. I am about 1/2 inch above orange dot 5 at the lowest wetted point and at the slit with labia. I am 2 inches in diameter. You can not get that from orange.

First things first I highly recommend consulting with the surgeon on their experience with swelling and pain from dilation.  I am not a doctor.

The second issue RBL recommended stretching my labia to the bottom. She said it could split from sex. I have a lot of sex and some of the guys are very large so that option is out.

I may go back to Dr. McGinn for additional vaginoplasty. Last time she injected fat in the top 2/3 of my vagina and it made a huge difference. Si If I have fat injected on the lower 1/3. I think it would be awesome. I am at Papillion next month and I may inquire.




Dorit:
I had similar problems and went to a physiotherapist that specializes in pelvic floor problems for women and has experience with transgender women.  She showed me a number of stretch exercises to do that would help, I have  five photos of them. She also brought out a vibrator, showed me how to use it, and recommended it for releasing the muscle tension in my vaginal area.  She also said that I might just enjoy it too! If you would like, I can send you the photos.

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