8 weeks post op anterior, posterior , midline vaginal repair with mini arc . pain at midline repair only during intercourse?

no s/s of infection , just extra tender at midline repair during intercourse. Feels as if I am extra right. and not stretchy enough ( not complaining ) Lastly , a decrease in natural lubrication post op surgery ? will these most likely improve ? I understand I can use synthetic lubrication ... will the midline become more flexible ? cream ? massage ? dialator?

Doctor Answers 2

Inelastic + Vaginal Tenderness after AP repair + Sling

If it's the sling site that bothers you, it's not going to go away. The material is inelastic and nonabsorbable. If it's the posterior vaginal wall and perineum that bother you, just keep having sex & it'll improve over time. Lubrication issues need a little more context. If you're in the menopause, vaginal estrogen is usually the first choice for women with a sling. If you're not in the menopause, vaginal infections are the primary reason.

Pain and dryness after Vaginoplasty, Perineoplasty

A common issue after a vaginal tightening operation with plastic repair of the opening (aka Perineoplasty, "posterior repair," etc.) is initial discomfort with sexual intimacy, and change in outside lubrication.

In this procedure, the surgical scar is in the mid-line at the opening, and not infrequently it "takes a while" to resolve and stretch.  I recommend to my patients that they undergo a course of gentle vaginal stretching with local estrogen cream.  You would have your surgeon Rx a tube of "estradiol" or "congugated estrogens" cream, and put ~ 1/2 gram (a small amount) just inside the vaginal opening with the applicator every evening for 2-3 months, massaging a bit into the incision line.  Additionally, and separately, you can use your thumb, or your partner can use his or her fingers to, once or twice daily for several minutes, to gently stretch or "iron out" the opening posteriorly, using a silicone vaginal lubricant like "Wet Platinum" or "Pink Silicone," or a light vegetable oil. You will find that, most times, everything will resolve within 2-3 months.

These same lubricants may be used on the outside, lovingly and generously applied to your partner's penis and your opening, for outside lubrication (Enjoy!).  Not infrequently, the openings of the "Bartholin's Glands," the lubricating glands located just outside the vaginal opening at ~ 5 and 7 o'clock, are removed along with the repair, resulting in diminished outer lubrication with sexual arousal.

Hope this helps.  Very best,

Michael P Goodman MD

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.