Original article created for T-Vox
Aftercare will, of course, vary tremendously whether mtf or ftm. However, it is advisable any surgery that is considered major to not strain yourself as this can cause damage in areas that are still healing. In addition, your body will be expending a lot of energy on the healing process which may make you feel weak and tired, at least in the early stages of recovery. The severity and longevity of this will vary depending on person to person as well as due to their health and fitness immediately prior to surgery.
Male to Female
Aftercare post SRS for mtf transwomen will predominantly consist of a dilation regime. These can vary depending on the surgeon used as well as their technique. Regardless of this, dilation will be necessary to avoid shrinking of the neo-vagina and to prevent or limit the formation of scar tissue.
Typically the patient will be supplied with dilators or stents. These can vary in look, but usually are long, cylindrical and taper at one end to a blunt point. They come in varying diameters and can be either metric or imperial. Usually the patient will begin with the smaller diameter dilator then after a period of time move up to the next size. Some dilation kits supplied by surgeons can have just two dilators, others can have as many as five or six.
Dilation is done usually when lying down with the torso slightly raised. You may find pillows to rest the knees on helpful too. You are trying to keep as straight a passage for the dilator as you can from the vaginal opening all the way up to the top of the vagina.
It is important to use plenty of lube. There are many brands available, but all should be specified for use within the vagina and should be sterile. Sealed tubes such as KY and Aqualube will be sterile within the tubes they are supplied in. It may also be necessary to apply lube into the vaginal opening with a finger prior to insertion. Withdrawl of the dilator to re-apply lube may be necessary several times before the dilator reaches full depth.
When the dilator is at full depth apply an even pressure to the end. Do not worry about 'pushing it through the end' of the neo-vagina; that is pretty much impossible. Pushing too hard can cause bruising though which may make subsequent dilation painful and more difficult.
Why is dilation necessary?
Dilation is necessary because your body is not genetically programmed to have a hole there. Left to its own devices your body will simply start to heal. The neo-vagina won't diappear, but it can shrink and tighten. Ridges of scar tissue can also form, making both depth and width diminish. By regularly stretching the skin inside there, you help prevent your body from forming the scar tissue.
This can occur as the body heals. It is essentially a build up of scar tissue. It can cause painful dilation, but can be repaired easily by a GP/Doctor using a silver nitrate solution.
See main article on Granulation
Do's and don'ts
- Do take your time when dilating
- Do relax - the pelvic floor muscle may proove difficult to get the dilator past if you are tense
- Do use plenty of lube
- Do take particular care over the cleanliness and storage of your dilators
- Don't over exert yourself - this can cause bruising
- Don't spin the dilator or twist it excessively - this can put strain on healing sutre lines
- Don't skimp on the dilation regime your surgeon recommends - this can cause loss of depth and more difficult dilation later on
Some people find that they can use the time whilst dilating to watch DVDs or listen to music; it need not be seen as a chore, but rather an opportunity to relax a little.
The dilators must be cleaned after each use with a cleaner such as Hibiscrub - other brand names may be recommended by your surgeon. If in doubt, ask. All lube and debris must be washed off using the solution then the dilator rinsed with clean water. Once this is done it must be dried, then preferably stored in a dry, air tight container until next needed.
Douching may also be recommended as part of your immediate post surgery regime. Your surgeon should provide you with a douche, which will resemble a squashable bellows container with a spout that can be inserted into the vagina. When the bellows are squeezed then the liquid within is expelled into the vagina, flushing out any debris (it makes more sense when you have seen a douche in the flesh). Replacement douches can be easilly sourced from adult sex shops where they are used for anal preparation prior to anal sex.
Douching is not recommended in the long term, as it can affect the natural balance of bacteria within the vagina. All natal vaginas have a bacteria culture, and when healthy this protects the vagina from yeast and fungal infections such as Thrush. Excessive longterm douching can leave a vagina prone to these infections. Your surgeon should provide advice on how long to continue douching.
And finally, remember a vagina is higher maintenance than a penis! Even without the need to dilate for transwomen, the urinary tract is shorter leaving it more prone to infection and between the labia can provide a home for alsorts of bacterial and fungal nasties if not kept clean.
A slight musky smell is normal - all humans have a natural smell. Any 'cheesy' or creamy deposits, especially on the dilator could be an infection, especially if they smell particularly unpleasent. Remember though that at least for a few months post surgery, sutres will dissolve and break free and these could look similar, although they will not smell bad.
Female to Male
I have no experience in this area - can some-one else with experience add to this article?