Community Conversation > Gender Correction Surgery

Managing pain after vaginoplasty

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Asche:
I recently had vaginoplasty.  They sent me home yesterday with, among other things, a little bit of oxycodone, but I'm having requent urethral pain, which only the oxycodone seems to control (I'm taking all the other pain meds they sent me home with as well.)  The other thing is that dilation is very uncomfortable to the point of being borderline painful.  I could probably live with that, but not if I have the other pain as well.  At the rate I'm using the oxycodone, I'll be out in a day or so.

Does anyone know of any tricks for managing the pain without using oxycodone?  Any OTC medications (I'm taking tylenol, ibuprofen, and gabapentin already)?  Other things (baseball bat? :-) )

AnonyMs:
OTC drugs are not very strong, although a little stronger when you mix compatible ones like you are. I dont think there’s any OTC drugs that are much stronger. If it was it wouldn’t be otc.

Oxycodone is quite addictive of course, but there’s other fairly strong prescription drugs that are not as addictive. I’d try to get some asap. For example, tramadol and a new replacement, Tapentadol I think. Lots of people have unpleasant side effects with tramadol. It can be really harmful if you have severe untreated pain. I’d do everything possible to avoid it.

Ms. Grey:
After consulting with a pharmacist that I know they said this.
It sounds like you are still trying to "get ahead of the pain".
The amount of Oxycodone that you were prescribed was probably just enough to get you home and settled for two days or so. You would have to ask if a refill is possible for that. You do want to be careful because it is a narcotic and for several reasons you do not want to be on that for an extended period if avoidable.
Taking the Tylenol, especially with codeine (1,2 or 3) is a good step down from the Oxy and Ibuprofen is fine to do but try to take them at separate times and as directed. Take the Ibuprofen with food even though they are a coated tablet or caplet.
If the pain is constant follow the schedule of 1-2 tablets 4 times a day or every 4 hours and no more than 8 per 24 hours. That is per the instructions on the box of Tylenol. Which will also tell you that if that schedule is not managing the pain after short amount of time then you need to consult a doctor or visit an emergency dept.
You could try CBD if that is available to you? They can help with pain and can also help you sleep.

I found soaking in the tub very soothing, be certain that the water is only quite warm but not hot.
Be certain to dry yourself completely as keeping the surgical site dry is quite important for faster healing.
If this pain is being managed by the Oxy or anything else then you are within the range of normal for pain at this point but of course you will want to see improvement soon. Do get in touch with your surgeons office to ask about refills and pain management. Can you inquire with you family doctor?

It is very important to continue your dilation routine as this is a vital component of the aftercare.
I recall my surgeons post surgery instructions being very adamant about keeping up the dilations which were three times a day for the first month.
I am sorry that it is painful for you and I hope that you will get the pain well under control very soon.
I hope that you can tell us that you are feeling better soon as well.

Rakel:
You should not be having that much pain post op. A little disconfort is normal, but not severe continuous pain.

Having said that, everyone has a different response to a painful situation, regardless of the cause. Some people handle pain very well and others not so well. It could be that something went wrong or most likely, you just need more pain medications.

First thing in the morning, you need to call your surgeon and tell them what is happening.

Now that you have called your doctor, lets talk about the addiction liability. Yes, Oxycodone is a narcotic with the possibility of you becoming addicted, but you have to take large quanities for weeks on end before this happens. Since you mentioned that you just had surgery, I would think that you are not even close to becoming addicted. Some people just need a higher dose to stay comfortable after any surgery. Keep a record of when and how much Oxycodone you have been taking and show this to your doctor. It will help them to prescribe an appropriate dose and quanity for you.

One last thing, some people abuse Oxycodone, but not everyone. The few people who are addicted just make it worse for those of us who need pain relief for medical reasons.

Asche:
I'm planning to call the surgeon's office in the morning (that's about 4 hours from now.)

I've been more or less in pain since coming out of recovery.  (In recovery, they gave me what I've been calling "happy juice" so I felt the pain but didn't care.)  The only times I wasn't in pain was when they gave me the oxycodone, and that wasn't always enough.  (I also haven't slept more than an hour or two at a time since the surgery.  At least, I don't recall a long period of sleep.  At this point, things are a little foggy.)

Last night, I localized one site -- there's a line of stitches (on each side) leading down to the neovagina, and the part near the opening on one side hurt when I pressed.  I tried some lidocane creme (from pre-op electrolysis), and it made it a lot better.  However, when I dilated, there was a fair amount of blood, enough to make a puddle on the pad ("chuck") a few inches in diameter when I was done.  But the lidocane creme doesn't seem to work any more.  (Maybe it's another place now.)

BTW, I think there's no longer pain in the urethra.  It's a bit hard to localize the pain, since everything is moved around, but I think that some of what I thought was urethral pain was actually someplace else, like those stitches.

This has been wearing me down.  At this point, I automatically anticipate pain for almost anything anyone does, which probably makes things hurt more than they might otherwise.  Sort of pain trauma, I guess.  So stuff I might have blown off freaks me out.  Also, I have the feeling that no one has taken the pain seriously.  (A common complaint by cis women.)  Before surgery, they said they were going to "manage the pain," but it doesn't seem like they really did anything. I would say, it's a 7 or 8, and they would just say I'd have to wait a few hours for the scheduled time before I'd get anything. Several mornings, I kind of fell apart and cried from the pain and the endlessness of it, and I can't even talk about it without bursting into tears.  (I guess I've finally learned how to cry :-( ).  I communicated with some people at the surgeon's office after I got home, and I got lots of sympathetic noises, but no sense that they saw any need to do anything.

It's not like I regret the surgery (not that it would do any good.)  But recovering from it has already turned into a nightmare.

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