Saturday, 31 January 2015

Dilation FAQ's

I have been referring to dilation even before I had my surgery and it occurred to me that many will not understand what this is or why I need to do it. Therefore I decided to give a quick guide to the ins and outs of the process because something I have found when speaking to those considering GRS, is that the whole dilation process seems to be shrouded in a veil of mystery. 

I have covered the basics here, but if there is anything anyone would like to ask, then please feel free within the comments section or email me here. I will add in anything I feel is relevant.

Why dilate?

The process of GRS creates a vagina from the penile (and sometime scrotal) tissue within a cavity of the body above the rectum. This was never intended for this purpose and the problem is that everything around wants to press in and close the neovagina. Dilation is the process of stretching this tissue and keeping everything open. It also aids in keeping depth for vagina.

Meet my boys!

I have showed these to two people in the last week and they seemed surprised at what they looked like. So here they are for everyone to see. They are hard perspex and very smooth. The two on the right are the 25mm and 30mm that Brighton send you home with and the one on the left is the 32.5mm that I bought and have already incorporated into my regime. I also have three more for the future that go up to 40mm! 

The preparation for dilation:

When you are first taught this process, it seems complicated because 90% is preparation. Once you start, you are pretty much stuck on the bed so having everything to hand is vital. At the moment, I fold our duvet in half and lay out the following on the bed:
  • A baby changing mat to lie on (this is super easy to clean afterwards)
  • A mirror
  • Several sheets of kitchen towel
  • My glasses (I need them for distance and they help me see everything easier)
  • Hand sanitiser
  • The dilators I am going to use, which were cleaned after the last session
  • A small torch (this is to help see when inspecting suture lines on the outside)
  • KY jelly for lubrication
  • A book to read (optional; some find TV a good idea)

I also put on some music, some people say relaxing is essential but I feel it is more about what you enjoy and I find Iron Maiden particularly helpful. I have also fitted a very bright light bulb in our bedroom, it lessens the relaxation but aids in visibility; over time I will probably change this back to a normal light.

The process of dilation:

***Please note***: What I describe is my experience of dilation and will vary greatly to anyone just starting out. I had a good amount of penile tissue to create my vagina and this has made me more stretchy and pliable than many others would be. I am just passing on my experience and this should not be used as a guide to dilation, stick to what you have been shown and modify it according to your own needs.

First, I lie on the changing mat and then I sanitise my hands with the hand sanitiser. At this time, cleanliness is vital because there are open wounds externally and internally and it would be easy for bacteria to enter. Another point to make here is that fingernails must be kept short. Your vanity must be thrown out the window for a time, those claws need to be filed back to the bone! I also take a piece of kitchen towel and place it under my bum, this makes it easier to clean the mat at the end because lube is going to slide down my backside.

I select the smallest dilator I am going to use and apply lube to it. Originally this consisted of placing a large blob on the palm of my left hand (reverse for lefties). I then take the dilator and twist it through the blob to coat it. This was shown to me in hospital and is ever so simple. I now find though that this was very wasteful and overloaded the dilator for my needs. I now simply apply lube straight to the tip and coat it all around with my finger. The last 3 inches of the dilator need to be kept free of lube or else I can't grip it.

I then put a small blob of lube on my finger and then insert this into the vagina to find where I am supposed to be aiming for and also to find my pelvic floor muscle. This step was important at the start because it also added a little more lube inside to help with things. With my finger inside I slide the dilator down towards the pelvic muscle and when I reach this, I have to drop the angle of the dilator so that it is more in line with my body. Gently you then push the dilator until it finds the back (vault) of the vagina. You know when it is there because you can feel it inside and it simply wont go any further. It is described as when the dilator bounces back, but I am not so sure this is a good term because it does not feel like that to me. 

I then hold this dilator in for 10 minutes. It seems a long time, but it passes surprisingly quickly and I have found reading is a good way to pass the time. I still need to hold the dilator with one hand and reading with just the other hand took some practice but it is possible. Once the 10 minutes are up, I gently pull the dilator out and then wipe it clean. It's is wrapped in kitchen towel and I then repeat the process with the next sized dilator. 

When finished, I get off the changing mat and wipe the area gently with the piece of kitchen towel that has been under my bum, remembering always to go from front to back. A quick spray of the changing mat with anti-bacterial spray and a wipe down prepares it for the next session. I then troop off to the bathroom for a shower, gentle clean of the vagina and the all important douche to clear the lube that has been left inside me. When cleaned up, I then take the dilators and wash them with Hibiscrub, an antibacterial scrub. They are wrapped in kitchen towel ready for the next session. I currently do this 3 times a day.

What does it feel like?

The all important question! Some assume that it is an erotic, sensual or sexual experience. This is actually not the case at this time. The dilators might look phallic and dildo-like, but they are surgical instruments and super smooth. They impart very little sensation because of this smoothness. For me, there is no pain whatsoever when inserting them, and never has been. I know some do experience pain initially because of the swelling but because I followed the directives of the nurses whilst in Brighton, I find my swelling has been minimal. The reason some have this initial pain is often swelling on the pelvic floor muscle and this does diminish over time. There is suggestion that long term pain with dilation is the result of not doing enough. It then becomes a viscous circle, who wants to do something painful? The evidence is there though, do more dilation, fight through the pain and it becomes easier over time.

It does have some sensation though, not pain or pleasure but just a feeling. That feeling is still indescribable, probably because it is so new to me. I would say it is more towards pleasant than not. The whole experience is quite relaxing and enjoyable and I have tended towards embracing it rather than see it as a chore. I need to do it, so I make it a part of my life.

Another benefit of dilation:

I have done some thorough research into dilation and found something that really piqued my interest. Research has suggested that dilation has another benefit than just keeping the vaginal canal open and toned. A woman born with a vagina has everything in place to hold its structure and this keeps everything around it in the correct position. Having a created vagina means this is not the case and dilation helps with this. By doing the work with the dilator, it props up the top structure of the area which means the clitoris and urethra are in better positions. Rigid dilation helps with urinal spraying and this I have noticed since the catheter removal. My first visit to the toilet after any dilation (once the lube is removed) is by far the most accurate, with a strong flow downwards. As I approach my next dilation, this flow tends to go a little more sideways. I have also noticed that towards the end of the first week after the catheter has gone, that my flow is definitely improving.

Advanced dilation:

The schedule I was given when I left hospital is very easy going compared to other surgeons in other parts of the world. We are given those two dilators and told that we can explore bigger ones in the future if we wished. I did my research very quickly and because I could accommodate the standard dilators very easily, I then purchased a graduated set. The day they arrived, I tried the next size up and whilst it needed extra gentle insertion, I found it was not difficult in any way. There was no pain and no blood when withdrawing it. I am now slowly incorporating this into my schedule and in a couple of days expect to be using it for all three sessions. I am also starting to find that the 25mm one is stupidly easy to insert and feel in a week or two, I will be removing this one from my schedule. At some point, when the 32.5mm is easy to insert, then I will sterilise the 35mm and try that one out. A schedule I found from a surgeon in Canada reveals using a 38mm dilator in the second month! This makes that 30mm "large" one I was sent home with seem tiny in comparison!

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