Follow Your Routine Dilation Schedule Properly after Sex Reassignment Surgery (SRS) – If You Don't Want to Lose Your Neo-Vagina!
Vaginoplasty is a Gender Reassignment Surgery procedure that transforms the transgender person's genitalia into female genitals, including a neo-vagina. To achieve the best surgical outcome and maintain a good functional vaginal depth after sex reassignment surgery, the patient and the surgeon share responsibility.
Dilation is something you have to do if you have sex reassignment surgery (SRS). Post-operative vaginal dilation is an integral part of initial surgery recovery and the regular maintenance of a transgender person's neo-vagina. If you do not dilate, the vagina will tighten up and you will lose depth and width and may not be able to get back.
Dilation is a torture; there is nothing fun about it. It hurts, it’s uncomfortable, and is very time consuming. Dilation begins a few days after surgery and is almost always required for life. It is essential to follow your surgeon's dilation protocol in order to prevent loss of depth of your new vagina although dilation may not be pleasant.
The purpose of dilation is to maintain the depth of the neo-vagina. The stretching force from vaginal dilation can prevent skin graft contraction inside vagina and also improves the elasticity of vaginal wall in order to comfortably accommodate penetrative sex. The skin inside the vagina tends to shrink or contract which lead to the shortening of vagina without adequate and correct vaginal dilation.
The vaginal dilation program focuses on total time of your everyday dilation requirement which is around 2-2.5 hours per day. It is recommended to do vaginal dilation 3 times per day (50 minutes in the morning – 50 minutes in the afternoon – 50 minutes before bedtime) during the first year after SRS, which is considered better than 2 times per day (100 minutes in the morning – 100 minutes before bed time).
First, the gauze packing (formed like a tube) will be used to stabilize the skin graft inside vagina around 7 days. The speculum is inserted into the vagina for examination of the skin graft when the gauze packing inside vagina is gently removed. Your original vaginal depth will be confirmed by measurement scale on dilator shaft at the point of the vaginal opening. Then you can start your dilation procedure.
Dilation involves inserting a lubricated dilator into the neo-vagina and keeping it in there for a specified amount of time. The provided dilators vary in different diameter (5 sizes) and the length of each dilator is approximately 8.5 inches. Dilators are comprised of the biggest no.4 with 32 mm diameter, dilator no.3 with 29 mm diameter, dilator no.2 with 26 mm diameter, dilator no.1 with 23 mm diameter, and dilator no.0 with 20 mm diameter. The size of dilator and the length of dilation time varies depending on the surgeon's protocol and patient's needs.
It is important to follow the advice of your surgeon about the proper use and frequency of post-op dilation as it may be specific to your case. Dilation should’ve gotten easier after scar retraction phase, which is from two to four months.