Bleeding from dilation

[suzifrommd]

I'm about 2 years post-op. My surgeon's dilation schedule went out through 18 months, which I followed religiously. After that, she encourages experimenting and finding the dilation schedule that works best.

I'm now dilating once every two days. It seems fairly comfortable, but occasionally I'm seeing a little bit of blood when I wipe the dilators down and on the pads in my underwear. Today it was more than a few drops, there was a marked smear down the dilator. All bleeding stopped a few minutes after dilation, so it healed quickly, but I'm curious if other people have had this.

Has anyone else experienced this sort of bleeding.

[AnonyMs]

Perhaps related to this?

https://www.susans.org/forums/index.php?topic=209413.0

[Cindy]

Just being clinical for a moment to a friend,

Just working through the obvious as I know you look after yourself.

Infection.
Granulation?  but should have noticed

Do you have odour? suggesting a yeast or bacterial infection?
(based on the neovaginal mucuosa is less resilient than the home grown variety)

It has dried up? You are not continually leaking? I'm looking for a capillary burst. There are no arteries involved so the leak will be minor and non-threatening.

You are not passing blood in your faeces? Looking for a fistula.

Keep hygiene very high.

Be cautious I don't want you to get a UTI so drink heaps of water. (Danger of passing an infection over to your blood stream).

Don't panic!

Cindy

[2cherry]

Wow, once every two days after 2 years?  Can't imagine how you put up with that...

After a year I went down to once a month. On two years, still once a month.

Could it be you do it too much?

My surgeon told me (privately) that he doesn't understand that other surgeons tell their patients to follow such a lengthy dilation schedule. Maybe because of liability or something? Because scars have settled after 6 to 12 months, meaning that it is pointless to alter their shape or flexibility. The only gain you get is that the skin gets used to being stretched, but since skin renews itself in 4-6 weeks and doesn't retain a memory, once a month would be fine.

My surgeon also warned: don't clean too much. I was told once in 3 weeks after 6 months post-op. I followed that, and had no problems whatsoever. But yeah, I don't know, every surgeon is different I guess.

I can imagine that the skin can get scratched by dilating, could be something very tiny though...  but if you dilate every two days, I guess there isn't enough time to heal that wound. If it's really bleeding and doesn't stop, seek help ASAP.

[Jenna Marie]

It might be worth raising the issue with a GP if you have the patience, because having someone take a peek with a speculum can set your mind at ease, but it sounds like this is relatively slight amounts. My own GP said that after everything was healed up, the vaginal skin would become much like a cis woman's, and that they sometimes do have "micro-tears" and slight bleeding from friction and abrasion. I'm 3 years post-op now and I've seen a smear of blood once or twice in the last year; as long as nothing hurt, there were no other symptoms, and it didn't get worse, I basically kept an eye out for a few days just to be sure.

You can try using more lube, in case it *is* friction. One thing to keep in mind is that the less frequently you dilate = the less lube will be left over in there from the last time (it does work its way out eventually). So the tissues may be more dry and prone to abrasion than before. My GP recommended the Vagisil lube (not the various medicated treatments the brand offers; there really is a lube) because it's also what he suggests to cis women with vaginal dryness; it restores the natural moistness to some degree and lingers longer than others. I can attest that it's worked for me.

[Dena]

After everything healed correctly a few months after surgery there was no more blood in my case. Because the dilator is hard, I insert it slowly and don't force it. I also really glob the lub on and dilate with an old bath towel under me to catch the excess. I also vote for an internal examination with your surgeon or a gynecologist to ensure there are no problems. If there are, I suspect they can be quickly treated in the office at the time of the exam.

[kimbee777]

If it's just spotting than it's most likely a micro-tear or a small amount of granulation(which seems unlikely for 2 yrs post-op). If there's no pain or discharge you're surely fine. For what it's worth, my gyno told me it's normal to bleed a little after dilation/sex.

[suzifrommd]

There was no problem when I dilated today, so I don't think it's a chronic problem like granulation, infection or fistula. It's something that happens occasionally. I did have an internal exam last year by a gyn who had worked with some other post-ops and she said everything looks fine.

I'm ruling out a problem with lube. I do use plenty of lube, though I'm pretty moist to begin with.

A tear or a scratch sounds a bit more likely.

Wow, once every two days after 2 years?  Can't imagine how you put up with that...

I might be over cautious. There was a discussion here a few years ago, where women who were long post-op disclosed their dilation schedules and the least frequent was once a week. I do plan over time to try doing it less often, though I was wondering if the blood was a sign that once every two days wasn't often enough.

[Jenna Marie]

Yeah, if it's gone today, it's almost certainly a situational problem such as a minor tear or scrape. The tissue can become quite thin and fragile (in a good way - this is how vaginas are supposed to be) over time, and delicate highly vascular areas can bleed what seems like an awful lot for a very slight injury. I'm glad it didn't recur!

BTW, I've sort of accidentally ended up dilating more like once a month now... since I'm not seeing any problems when I do, I figure this schedule works, as you've said as well. I could easily see the frequency decreasing to close to a couple times a year by the time I'm a decade or more post-op.

[Doreen]

I basically had a period for 2 years post op, and it was very irritating and somewhat painful.   Basically it was an unhealed skin portion on the inside, and I had to use pads.  I got my gynecologist to use silver nitrate twice, second time it FINALLY cleared it up thank goodness.   I still get irritated down there, especially if I'm crazy enough to start shaving, but for the most part its healed up now (Going 15+ years post op with Dr. Kunaporn now).