Still unable to have sex 8 weeks after vaginoplasty.

At 7 wk me & my partner attempted to have sex with me on top we tried again at 8wk & still no success it's so frustrating. We used lubrication but it seems as if the new bit of tissue from the stitching is blocking my vagina opening.My partner has managed to get one finger in my vagina just don't understand. I don't think it's to tight but then I'm not a surgeon to make that judgement. I'm booked in with the clinic nurse next week but got no further appointments with my surgeon.

Doctor Answers 9

Too tight after Vaginoplasty?

I would certainly recommend that you demand to meet with your surgeon, as this is obviously troubling to you. I do want to reassure you however, that this is not an unusual concern. This soon after surgery there is still significant swelling and tenderness, especially at the vaginal opening. In my practice, I have my patients perform vaginal stretching exercises with estrogen cream for 2 weeks after we lift restrictions to aid with those issues. If your surgeon feels your vagina is too tight, this can usually be addressed in an exam room with a short procedure. Cheers!

Blocked opening

Dear  Beckie

No reason to panic and remember you can still be swollen but it does sound like things are too tight.  Perhaps not too tight through out the length of the repair but maybe just at the opening.   If it really is just your vaginal opening which is too tight, it has been my experience vaginal dilators do not often work. I am not saying that they can't but it is less often to be successful than the interior of the vagina.  If it is just the opening your surgeon and you will make the decision if you would benefit from going back to surgery for a revision of this area which usually takes less than 20 minutes. 

If you are indeed to tight on the inside of the vagina Dilators might be the way to go then again it depends on how tight you are.  It has been my experience if the whole length of your vagina is only 1 finger breadth it is unlikely the dilators are going to work in 3-4 weeks it will take much longer and sometimes 6-12 month and sometimes it will not dilate at all because the scar is too mature and strong.  If your whole vagina is too tight you need to have a candid discussion with your surgeon to see his/her experience with dilation and recommendations for surgery.  Many of my patients do not want to wait to dilate and then find out it may not work.  In this situation I would take them back to surgery to alleviate some tightness i.e. some revision.  

This is not a simple answer as you and your surgeon ( based upon his/her experience and skills and you personal timeline) need to make a decision together to choose an appropriate plan of action that will benefits you both physically and socially.  The very best of luck with your healthcare.

Sincerely

John R Miklos MD
Atlanta ~ Beverly Hills ~ Dubai

Need to see a surgeon and not a nurse

Sorry to hear about your situation but there is so much that can be done to help you feel better and a surgeon should really be advising you on this.  
Please make sure you are seeing the expert for advice and instructions on how to improve your situation.

Best of luck 

Too-tight vaginal opening after vaginal tightening procedure

Demand an appointment with your surgeon. (S)he charged you, and owes you good post-operative care). Excessive tightness of the opening is a known complication of perineoplasty/vaginoplasty, and the vast majority of the time is well treated by a combination of finger stretching and use of progressively larger vaginal dilators. Over time (usually 3-8 weeks), plus the addition of vaginal and perineal estrogen if you are near or after menopause, the opening will stretch & release its stenosis. Vaginas stretch; remember-- you had a child through there..!

Best,

Michael P Goodman MD

Too tight

Your problem is not unusual but have no fear, it does get better. Sometimes the vagina needs to be dilated after a vaginoplasty, either by your fingers or by vaginal dilators. Use lots of lubrication (I recommend coconut oil), and persist. The vagina will accomodate. Good luck.

Robert L. True, MD
Grapevine OB/GYN
4.9 out of 5 stars 7 reviews

Too tight 8 weeks after vaginoplasty?

If sex is uncomfortable, painful or impossible when you attempt to resume sex after vaginoplasty because it's too tight, you can stretch the opening with your fingers. If that's not enough, you can use dilators until you're comfortable. Surgical adjustment of a vaginoplasty is usually reserved for situations where dilatation doesn't work. Take it slowly and gradually. It might take a few weeks of regular finger massage and dilators before you can get on with the real thing.

Still unable to have sex 8 weeks after vaginoplasty.

Thank you for your question and I am sorry to hear of your procedural issues.  When a perineoplasty or vaginoplasty is performed to reduce the size of the vaginal opening, it will take some time to allow it to stretch after the swelling of surgery.  I would recommend seeing your surgeon for a follow-up to ensure enough space was left after the repair and to receive recommendations on how best to approach sexual intercourse. Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Unable to penetrate

Hello Beckie,
Keep your appointment with the clinic nurse so she can evaluate you. It isn't uncommon for penetration to  be difficult initially. This may be due to pain which results in you tightening up as a reflex. Ask her about vaginal relaxation exercises and dilatation which should resolve the problem.  If it doesn't then the "bit of tissue" may be the problem as it may be blocking the entrance. If this doesn't resolve you'll need a revision.
Best of luck, 

Oscar A. Aguirre, MD
Denver Urogynecologist
5.0 out of 5 stars 23 reviews

Exam

I would call your surgeon's office and request a appointment with the surgeon. I am not sure what type of surgeon performed your procedure but an exam by an ob/gyn trained in cosmetic procedures may be warranted. You may need to use serial dilators and pelvic exercises to re-stretch some of the tissues. I hope this helps. 

Jeffrey Jacobs, MD
Meridian OB/GYN

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.