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Community Conversation => Transsexual talk => Post operative life => Topic started by: 2124abc on December 27, 2014, 01:09:19 AM

Title: Dilating - holding it in or in & out quickly? - does it make a difference??
Post by: 2124abc on December 27, 2014, 01:09:19 AM
Hi,

My surgeon put me straight on dilator #3 (these dilators: https://www.vaginismus.com/products/dilator_set) because i had a skin graft so he said i'll be able to fit #4 (the big beast of a dilator), anyway 3 weeks since the op and iv had to downgrade to #2 because it just hurt too much to do #3. I now know to use the smaller dilator first before moving onto the bigger ones tho I haven't yet attempted #3 again, and iv ordered a dilator of width in between #2 and #3 from soul source website.

Anyway, my surgeon told me i just have to lube up the dilator (put a condom on it first tho so its easy to clean) and stick it in, count to 10, pull out and its done.

But the dilator booklet says to hold it in for 20 minutes!!!!

Can we discuss if there is a difference between holding it in to just putting it in quickly in terms of stretching and etc.???

Does it make a difference? Is it easier to dilate the next time if I hold it in longer? What is the correct way?

Help pls, thank u all :)
Title: Re: Dilating - holding it in or in & out quickly? - does it make a difference??
Post by: suzifrommd on December 27, 2014, 09:01:26 AM
I've never heard of a surgeon telling patients to put it in and take it right out again, but there are many different ways to do this surgery, and I'm not familiar with it.

If you're concerned, probably a good idea to ask your surgeon.
Title: Re: Dilating - holding it in or in & out quickly? - does it make a difference??
Post by: Jenna Marie on December 27, 2014, 10:59:01 AM
In general, obey the surgeon's instructions; they have a reason for the regimen they came up with. But I also have never seen this particular routine, and it couldn't hurt to ask what that reason is...

I was told to put the dilator in and hold it steady for a certain period of time (shorter for the smaller dilators, but never less than 5 minutes).
Title: Re: Dilating - holding it in or in & out quickly? - does it make a difference??
Post by: Cindy on December 27, 2014, 02:41:37 PM
May we ask who your surgeon was?
Title: Re: Dilating - holding it in or in & out quickly? - does it make a difference??
Post by: 2124abc on December 27, 2014, 03:15:41 PM
Thanks all, I seem to be alone here on this one, I have no idea why the surgeon told me to do it this way and I'll ask him when I see him early January. My surgeon was Professor Peter Haertsch.

He was quite unclear in hospital when he told me how to dilate, he said he expected I do it half a dozen times a day, and he also said every hour - which is confusing because those two are not the same, but a nurse who told me she dealt with many doc Haertsch's patients, she said to me the clearest he has ever been on directions is to put it in 3 times in one session, and then the next dilation to be 2 hours later, which freed up my time so much more than every single hour!

However this was still putting it in each time for only about 10 seconds, which is weird BECAUSE the booklet of the dilators said to hold it in for over 10 minutes AND the booklet HE GAVE ME regarding the surgery, written specifically for his patients, also says to hold it in for about 20 minutes, with intervals based on what the surgeon suggests or if it is too tight the next time shortening the intervals. We emailed him the day before xmas eve because I badly needed some painkillers, and anyway his reply said I can start dilating less, with intervals of 3 hours, so only 5 or so times a day.

Still unsure tho if it makes a difference? Any thoughts? Will it close over if i dont hold it in? Why is his booklet different to his instructions when he wrote the booklet?
????

ty
Title: Re: Dilating - holding it in or in & out quickly? - does it make a difference??
Post by: Cindy on December 27, 2014, 03:19:10 PM
I am not a surgeon and my suggestion is personal opinion only.

I would suggest following what the booklet says.
Title: Re: Dilating - holding it in or in & out quickly? - does it make a difference??
Post by: chinee05 on December 27, 2014, 03:51:25 PM
My surgeon also did recommend me to use dilator just for 10-15seconds per session 4-5x a day when i was still 1week post op. But since I already made my research and read forums about srs for years prior to my surgery, I already know what to do.

I just basically did not follow my doctor and just followed the default dilation routine. I am using soulsource dilators and im 2 months post op.

I only dilate twice a day and im on mr. orange already
Title: Re: Dilating - holding it in or in & out quickly? - does it make a difference??
Post by: 2124abc on December 27, 2014, 04:25:44 PM
thank u cindy i will switch to doing that now..

and especially glad someone else was given the same directions as me, chinee05, thank u soo much for your advice and the fact that uv done the research on the correct method is very promising. At 3 weeks do u recommend the 20 minute method for only 3 dilations a day?

Just so u know incase it makes a difference, doc started me on the equivalent of mr orange, and i had to downgrade to near equivalent of mr yellow (slightly less thick) so its only really the next size up is mr orange, because if this is a good thing that im only one size below orange then maybe theres nothing wrong with the way im dilating?????

Pls respond, thanks so much :)
Title: Re: Dilating - holding it in or in & out quickly? - does it make a difference??
Post by: Unrepentant on December 27, 2014, 04:53:40 PM
Email the surgeon for clarification?
Title: Re: Dilating - holding it in or in & out quickly? - does it make a difference??
Post by: chinee05 on December 27, 2014, 07:14:16 PM
i started using #2 (blue) of soul source for like a month then i started using #3 (green) starting my 2nd month. Yeah, its quite painful to use the bigger dilator the first time so what I do is I use #2 first then remove it and change to #3. I change them 10mins each.

Now that im on #4 (orange), I use #2 followed by #3 then #4 5-10mins each. This way its less painful and easier.  I tried to dilate 3x a day during my 2nd week but due to schedule conflict, I only do twice a day until now.

I know that 2x a day should be only done on your 3rd month or so but on my case my PC muscle down there was easier to be trained and not very tight to begin with
Title: Re: Dilating - holding it in or in & out quickly? - does it make a difference??
Post by: 2124abc on December 28, 2014, 04:36:03 PM
ok now theres confusion

when i said my surgeon started me on the equivalent of the orange dilator from soul source i was not talking about the GRS range but the Silicone Vaginal Dilators range, which is the same shape as the dilators he gave me.

should i have ordered the longer differently shaped GRS range of dilators from soul source? we ordered the silicone large pack a few days ago, since im not in america im not sure how long it will take because it might be a month or more before they even arrive.

are you talking about the GRS range?

and iv now increased the dilation time to 10 minutes on the 3rd penetration if that makes sense - so in and out twice to open it up and the third time really trying to relax the pelvic floor and holding it in for 10 mins, tho it feels like when i push it fully in i suddenly feel it tense up..
Title: Re: Dilating - holding it in or in & out quickly? - does it make a difference??
Post by: 2124abc on December 28, 2014, 04:39:42 PM
if this is so then iv got a big big problem because u said u started on blue which if its the GRS version its 1/1/4'' thick which is what he started me on and i found too difficult and had to downgrade to nearly just 1'' thick!!!!!
Title: Re: Dilating - holding it in or in & out quickly? - does it make a difference??
Post by: 2124abc on December 28, 2014, 04:45:08 PM
OMG I have screwed up havent i???

"Soul Source silicone dilators are hand-cast using 100% silicone rubber.  Silicone rubber is flexible and resilient with a texture that resembles body tissue.  Our GRS and Rigid Plastic dilators are hand cast using polyurethane plastic for situations where a rigid dilator is needed.  For quality assurance, all of our dilators are inspected, washed, and sealed before shipping."
Title: Re: Dilating - holding it in or in & out quickly? - does it make a difference??
Post by: Flan on December 29, 2014, 01:57:55 AM
Quote from: 2124abc on December 28, 2014, 04:45:08 PM
OMG I have screwed up havent i???

"Soul Source silicone dilators are hand-cast using 100% silicone rubber.  Silicone rubber is flexible and resilient with a texture that resembles body tissue.  Our GRS and Rigid Plastic dilators are hand cast using polyurethane plastic for situations where a rigid dilator is needed.  For quality assurance, all of our dilators are inspected, washed, and sealed before shipping."

You'll probably need to dilate longer but I wouldn't put down another $150 or whatever is it for replacement set so quick. As far as the issue of diameter, just take your time and try anyways and the skin will eventually expand. Maintaining depth is much more important at this part of recovery.
Title: Re: Dilating - holding it in or in & out quickly? - does it make a difference??
Post by: Jenna Marie on December 29, 2014, 10:35:51 AM
Flan : I would not recommend using silicone when immediately post-op. Brassard said that silicone is a) too hard to disinfect to the necessary level and b) too soft to be as effective in dilation (rigid plastic actually is necessary, since something which compresses = not expanding the cavity to the size of the dilator, width OR length).
Title: Re: Dilating - holding it in or in & out quickly? - does it make a difference??
Post by: chinee05 on December 29, 2014, 03:31:55 PM
I am talking about the hard plastic dilators from soulsource which is the dilator set used by most SRS surgeons.
Title: Re: Dilating - holding it in or in & out quickly? - does it make a difference??
Post by: Flan on December 30, 2014, 06:47:45 PM
Quote from: chinee05 on December 29, 2014, 03:31:55 PM
I am talking about the hard plastic dilators from soulsource which is the dilator set used by most SRS surgeons.
Then use the smallest that works and move up as you can (to maintain depth). It'll be painful a couple days when going up sizes but that's normal.
Title: Re: Dilating - holding it in or in & out quickly? - does it make a difference??
Post by: 2124abc on January 01, 2015, 10:12:49 PM
hi girls, i was wondering if anyone has figured this out yet  ??? ??? ???

my surgeon replied to my email and said as long as the dilator goes in then it doesnt matter if i hold it in for as long as the booklet says, as long as it goes in - thats literally what he said paraphrased

so my question to u is why does 10-20 minutes make a difference compared to just putting it in when doc says its ok?

why does it matter? someone pls answer the question with your thoughts...

P.S. i wish i had the soul source grs dilators, the crappy ones shown at the top of the thread are too short for the thinner ones meaning i cant push in the thicker ones to their depth since obviously the thinner one never went that deep ... stupid stupid stupid and now cos of it when i next see him im going to be in agony as he forces a dilation under local anaesthetic of the larger one, which btw i can no longer even put in the entrance of the hole without feeling like its going to rip down through my anus - literally thats the feeling i have, like pushing down on the bottom of the hole is the same feeling as if my prostate was being crushed slowly and painfully, i just cant do it  >:(
Title: Re: Dilating - holding it in or in & out quickly? - does it make a difference??
Post by: Flan on January 01, 2015, 10:50:07 PM
Quote from: 2124abc on January 01, 2015, 10:12:49 PM
so my question to u is why does 10-20 minutes make a difference compared to just putting it in when doc says its ok?

why does it matter? someone pls answer the question with your thoughts...
Holding the stent in 20 min (or whatever works/surgeon instruction) is because it forces the tissue to for lack of better words, tear. Intentionally. Otherwise atrophy would occur because skin tissues (penile/scrotal) vaginoplasty is considered a wound with all but full thickness grafts (which are pre-shrunk so-to speak).
Title: Re: Dilating - holding it in or in & out quickly? - does it make a difference??
Post by: mrs izzy on January 01, 2015, 10:58:37 PM
For interesting reading do a web search on

Why do post-op transsexuals have to dilate?
Title: Re: Dilating - holding it in or in & out quickly? - does it make a difference??
Post by: 2124abc on January 02, 2015, 03:19:24 AM
i think i had a full thickness graft, i had a graft taken from the scrotal skin... if that makes a difference to the topic at hand

i had a brief look but still want people's theory why there is such a difference between <1 minute to 20 minutes

surely 'tearing' or 'stretching' would occur either way

thoughts?
Title: Re: Dilating - holding it in or in & out quickly? - does it make a difference??
Post by: chinee05 on January 02, 2015, 08:34:25 PM
well based on my own experience, initially I was doing <1 minute dilation per session as this was the prescribed dilation procedure of my surgeon. But then later on I switched to 15-20 minute dilation per session and followed the default dilation procedure for soulsource dilators.

One thing I noticed was when I was doing the less than 1 minute was it was always hard to insert the dilator as the pc muscle really fighting it much. But then my dilation got easier when I switched to 15-20 minute session. Now my tightness down there has been normalized and sexual intercourse isnt that difficult anymore
Title: Re: Dilating - holding it in or in & out quickly? - does it make a difference??
Post by: lilredneckgirl on January 21, 2015, 07:12:03 AM
I  am  not  giving  medical  advise.  you should consult  your  doctors  as  to  their  recomended  methods.  dont  self  diagnose

  this is  what  I  was  told  to  do  in  dialiating.  [  15  years ago  ]
pre warm  the  dialiator  in  warm  water,  not  hot  water.  cold  causes  muscles  to  tighten  up.
use  a comfortable  size  dialiator,  apply  generous  lube.  Schrang  recomended  a  surgical  lube.  those  lubes  are  designed  not  to  'dry  up  or  get  sticky'  so  quickly.   
  insert  and  remove slowly,  two  or  three  times.  that  assured  full  spreading  of  the  lube. 
take  the  next  size  up,  lube  and  insert.    after  the  muscles  relax,  push  the  handle  end  down  toward  the  anus,  and  hold.    release  after  a  few  minutes,  rest  and repeat. 
  dialtion  sessions  were  every  4  hours,  for  20  minutes.
  in  the  early  days  just  after  surgery,  i  was  restricted  to  using  just  the  smaller  dialiators. maintaining  depth  was  the  goal.   about  a  month  in,  the  next  size came  into  use. 
  there was  always  caution  urged  not  to  push  to  far  or too  fast. ' let  pain  levels  be  your  guide'  was  his  motto.    there  will  be  discomfort,  but  you  should  not  have  severe  pain.

  the  old  style  dialiators we  got  at  the  hospital  had  5 " tools ".    the  biggest  is  huge,  and  honestly,  its  never  even  been  attempted.  {  If a  guy  is  that  big,  Im  running   :o } 

again,  consult  your  doctors  for  recomendations and  their  prefered  methods.   
Title: Re: Dilating - holding it in or in & out quickly? - does it make a difference??
Post by: lilacwoman on February 14, 2015, 03:37:15 PM
my surgeon said dilate one hour morning and night .
take some painkiller a few minutes before to try overcome pain.

get dilators that have lengthwise grooves as the plain clear solid ones just push the lube off and cause the painful 'stiction'.