D. Reed, Unable to dilate after my vaginoplasty elsewhere. Darlene
There are many reasons for inability to dilate after vaginoplasty. While prevailing suibject could be called “vaginal atresia“, the matter is often relates to the location of the vaginal opening or introitus. The opening must be under the pubic bone and about 3 finger breadths above the anal verge. The generally requires a perineal flap be brought in to create a funnel effect.
After the vaginal packing is removed (ion our practice in one week), the patient must commence dilation as shown either with hard silicone dilators or soft silicone vaginal molds, which are worn many hours every day. Providing the patient with only large diameter stents comparable to an erect penis is probably not the best way to start off. Smaller caliber stents will allow the patient to get started with a lot less discomfort and being able to pass the stent a lot deeper.
If the introitus can admit a 7/8” diameter vaginal stent, there is hope the vagina will accommodate and stretch when using followup larger sizes.
Harold M. Reed, M.D.
The Reed Centre for Transgender Surgery | Miami
Vaginoplasty dilation maintains depth and girth