Why does vaginal stenosis happen in transwomen and what is the solution to it? Dr Salil Patil has all the answers!
Who does it happen in?
Dr Salil clarifies that “vaginal stenosis doesn’t only happen in Trans people, it can happen to anyone.”
What does it mean?
“Stenosis”, Dr Salil says, “means that the space has decreased. So when we create a new vagina, as we discussed in the skin grafting method, it is the property of the skin that it slowly gets tighter as it contracts and so that is why stenosis happens.”
“When you use flaps, the flaps are from the beginning, a little thick. Because of this, there might be a little less space on the inside. So because of this, there is a feeling of semi-stenosis or false-stenosis.”
“When penis skin is used then this issue is not that pertinent. Not even in bowel and even in peritoneal technique there are very less chances of this happening.”
How to prevent it?
“This can happen to anyone” Dr Salil says. “For it to not happen to you the most important thing is using dilators. Vaginal dilators exist, after your operation, you are provided with a dilator set. It has different sizes, you are given a schedule which ensures how you should use it.”
“The other thing is that you have to use lubrication inside your vagina. Normally too, if you use lubrication or moisturizer that would ensure that your stenosis is less. If you have an injury or such, it helps in preventing injuries so that is definitely something that you can do.”
“Keep up with dilation regularly. And as soon as your normal intercourse starts, it becomes natural dilation. This takes care of your stenosis.”
“So coming to rare points, some people might have some diseases, some infections. God forbid but some may have an infection in the surrounding areas if they have cancer there so there comes the concept of radiation therapy. And after radiation therapy, there are chances that stenosis might happen. If there is such a disease, such a reason then surgery can also be done on you which would then make sure that the stenosis opens up and there is a new covering or layer which would assure that your stenosis would decrease.”
“Stenosis also has other reasons like anxiety, stress, tension, and excessive muscle tightness. To relieve this, Doctors need to talk to us. Then the Doctors have to get to the bottom of what is the cause of our stress, what is causing us all this anxiety. If you can relieve this then it will get better.”
How can we relieve anxiety?
“Counselling so that it clarifies that what you are doing is not a painful thing. Initially, you feel a new sensation, you feel a little pain but it will stop hurting. You have to calm the person down and relax them. To relax us, councilors could teach us meditation, exercises, and physiotherapy, if there is excessive tightness in the muscles then you can loosen them. So these are the techniques by which stenosis can be gotten rid of. So stenosis that happens or the one that is because of external factors can be apparated and avoided.”
Pelvic floor therapy
“The stenosis that happens because of the outer muscles of the body or because of excessive muscle tightening or because of anxiety induced muscle tightening. If you are not able to adequately relax and want that activity, physiotherapy has a huge role. Stretching and pelvic floor relaxations, all these things happen in a lot of people naturally. Some clients can relax by themselves, but some clients can’t. Some people have really tight muscle and ligament tones that it is not possible in them. In these cases, physiotherapy and a physiotherapist can play a huge role. Without surgery and going through this you can get good results and that would save a surgical procedure.”