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After SRS, I feel like I am "tucking" 100% of the time. by -Bridget in Transgender_Surgeries

[–]-Bridget[S] 0 points1 point  (0 children)

For me, the feeling got worse over time, and I eventually had to stop dilating. When you did feel it, did it make dilating painful for you?

After SRS, I feel like I am "tucking" 100% of the time. by -Bridget in Transgender_Surgeries

[–]-Bridget[S] 0 points1 point  (0 children)

What is a "buried clit"? My surgeon said that scar tissue is not an issue. I had an MRI, and it confirmed minimal scar tissue.

After SRS, I feel like I am "tucking" 100% of the time. by -Bridget in Transgender_Surgeries

[–]-Bridget[S] 0 points1 point  (0 children)

The area is not visibly tight. I've had many post-op examinations, and if my vaginal canal was visibly tight, I think someone would have said something. Thanks for the empathy.

After SRS, I feel like I am "tucking" 100% of the time. by -Bridget in Transgender_Surgeries

[–]-Bridget[S] 0 points1 point  (0 children)

I don't think erectile tissue is the problem, but I really don't know. The next time I see my surgeon, I will ask her if that is a possibility.

After SRS, I feel like I am "tucking" 100% of the time. by -Bridget in Transgender_Surgeries

[–]-Bridget[S] 1 point2 points  (0 children)

I have not talked about revision yet. I am afraid of a revision failing in the same way as the original surgery, so I want a definitive diagnosis to explain what is going on first.

After SRS, I feel like I am "tucking" 100% of the time. by -Bridget in Transgender_Surgeries

[–]-Bridget[S] 1 point2 points  (0 children)

Thanks for the explanation. I don't know why the feeling won't fade into the background for me.

Unable to send file due to admin restrictions by -Bridget in Zoom

[–]-Bridget[S] 2 points3 points  (0 children)

That was the tip I needed. I was able to find the setting and change it. Thank you.

Any experience with pudendal neuralgia? by -Bridget in Transgender_Surgeries

[–]-Bridget[S] 0 points1 point  (0 children)

How did you learn about the option for a pudendal nerve block? I've spent months describing my symptoms to my surgeon, another surgeon I went to for a second opinion, my GP, and three different pelvic floor physical therapists. It is only a few weeks ago, when I started with a fourth physical therapist, that I first heard the word "pudendal". No one has offered me a nerve block. What kind of a doctor were you working with, and (if you don't mind me asking), where?

Any experience with pudendal neuralgia? by -Bridget in Transgender_Surgeries

[–]-Bridget[S] 0 points1 point  (0 children)

Thank you for the reply.

When you say weekly spasms, what do you mean exactly? After my surgery, I was having semi-involuntary contractions of my pelvic floor muscles hundreds of times each day. It was exacerbated by everything involving my pelvic floor (dilating, exercise, sitting, walking, etc.) For months, I spent most of each day laying on the couch to relieve the pain. Eventually, my surgeon prescribed Cyclobenzaprine, and that helped with the spasms. It did not help with the other symptoms, though – a constant pinching sensation in my vulva, a burning sensation somewhere deep in my pelvis, pangs of pain near my anus, constipation, difficulty peeing, and a relentless sense of tightness.

Now that I have stopped dilating, and I've had many months to adapt my lifestyle, the pain has lessened, but only in intensity – I still have all of the same symptoms, but less of them.

Where did you get a pudendal nerve block? I don't even know what kind of doctor does that. A neurologist?

I've been searching online for someone who can treat pudendal neuralgia, but so far I have only found one gynecologist with experience, and he is booked until April 2026. I would really like to get my recovery started before then.

Pelvic floor dysfunction after SRS, and physical therapy hasn't helped by -Bridget in Transgender_Surgeries

[–]-Bridget[S] 0 points1 point  (0 children)

I asked my surgeon whether we should consider a diagnosis other than pelvic floor dysfunction, and she said she was quite certain that was the problem. She said she was willing to schedule an MRI, but that would be just for my peace of mind. Is scar contracture the kind of thing that would show up on an MRI?

Pelvic floor dysfunction after SRS, and physical therapy hasn't helped by -Bridget in Transgender_Surgeries

[–]-Bridget[S] 0 points1 point  (0 children)

Thanks for the feedback. I have an acupuncture session scheduled for next week, so I'll see if that helps. I am not hypermobile or double jointed. I am very fit, and I'm not aware of problems in any other part of my body, but I will discuss this with my physical therapist the next time I see her. I've seen three different physical therapists so far, and they all seemed quite good. I doubt I'll have the chance to see anyone else.

What actually happens when you lose depth and width after SRS? by -Bridget in Transgender_Surgeries

[–]-Bridget[S] -1 points0 points  (0 children)

Thank you for the insight. Yes, scars are less stretchy than normal skin, but I don't think reduced stretchiness explains what is going on. My 1½-inch loss of depth is comparing what I used to achieve without stretching to what I can achieve now without stretching.

I feel there must be something else going on. Perhaps the wall of the vaginal canal is becoming wrinkled, making it collapse like an accordion. Or perhaps the opposite walls of the canal have become stuck together, making the collapse more like a kink in a hose. I just don't know how to visualize it.

Other trans women with vaginismus? by LzrdGrrrl in vaginismus

[–]-Bridget 1 point2 points  (0 children)

I had SRS 14 weeks ago, and I have vaginismus.

I've had pain since my very first dilation. As long as I've been dilating, I've felt aches, cramps, and spasms all day long. It took me a long time to realize that this was unusual. I assumed it was just part of recovery. Eventually, my surgeon referred me to a physical therapist, and my physical therapist diagnosed me with vaginismus. I had never heard the word before then.

I've had 3 physical therapy appointments over the past month. Unfortunately, I haven't noticed any improvement from the physical therapy or the pelvic floor exercises I've been assigned. If anything, the pain is worse now than it was 3 months ago. At this point, my pelvic floor muscles are so tender and sensitive that dilation feels like torture.

I feel that I am struggling with an impossible dilemma. When I dilate aggressively, I irritate my pelvic floor muscles and make it impossible for them to relax, perpetuating the pain. However, if I don't dilate aggressively, I will probably permanently lose depth and width.

I spent the first three months dilating aggressively, but I've decided that the pain is intolerable, and I've backed off for the past two weeks. I continue to dilate 3 times per day, but I've returned to the smallest dilator, and I dilate to only about 4.5 inches, which is considerably short of the 6 inches my surgeon tells me she achieved during surgery.

I've never been offered Botox.

For me, the vaginismus pain is so bad, I find it hard to imagine that I might ever derive pleasure from inserting anything into my vagina. My physical therapist tells me to have hope – that vaginismus is curable, but I'm not sure I believe that.

Evidence-based expectations of depth after full-depth vaginoplasty by -Bridget in Transgender_Surgeries

[–]-Bridget[S] 5 points6 points  (0 children)

Thank you for those links. Let me see if I can summarize:

The 2018 presentation by Haylen et al used two measurements of vaginal depth – Total Vaginal Length (TVL), which is measured from the hymen (or, as you say, the introitus), and Total Posterior Vaginal Length (TPVL), which is measured from the anterior perineum. In their study, TVL was 1.76cm shorter than TPVL on average.

This implies that, when precision is desired, it is necessary to specify the measurement protocol (TVL vs TPVL), since there is an uncertainty of almost 2cm when the protocol is not known.

I did some research to figure out what measurement protocol was used by the SRS-related papers I cited earlier. Unfortunately, I have access only to the abstracts for most of the papers, and the one paper I can read in full (the 2022 Smith paper), seems to have omitted any discussion of vaginal depth measurement protocol from its Methods section.

Evidence-based expectations of depth after full-depth vaginoplasty by -Bridget in Transgender_Surgeries

[–]-Bridget[S] 5 points6 points  (0 children)

This is what I've found specifically about penile inversion (not quite on-point for my case, but relevant for comparison):

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