I CAN FINALLY ENJOY SEX! 8 months post vulvar vestibulectomy update surgery

Just another update... and a good one at that :)

I'm feeling really confident that my vestibulodynia is is 98% gone!!! This is big news since I have been suffering with this for over 4 years... since I was 17! I have no idea what caused it because I experienced pain ever since my first sexual experience. It could have been birth control, it could have been excessive nerve endings, it could have been an injury... Actually after thinking about this a lot I realized there is a good chance it could have been the result of an injury I had the summer before I started having sex. I slipped and fell on my right hip and fractured a lower vertebrae. I didn't find out about this until 3 years later when I finally got an xray at the chiropractor because I didn't feel any unusual pain up until that point and the fall didn't seem that bad. This could have irritated up my nerve endings and caused lingering pain and muscle tightness in the pelvic floor. Either way... I don't need to worry about that anymore because now I'm feeling great.

I still feel some pain when I use my finger to gently stretch out the area but once I use my lidocaine, I'm invincible! It also seems to be an area that is not bothered during intercourse.. maybe a spot that was missed when identifying the painful area before surgery and therefore was not removed. I try at least 3+ times a week to basically massage the area down there and really stretch out the tissue. I also practice flexing and relaxing my pelvic floor before bed each night to make sure that everything down there stays calm. It's amazing the difference I can feel since before physical therapy. I also think getting a full body massage can help too by just getting everything to relax. You might have pain points elsewhere on the body that are affecting your pelvic floor.

I still use lidocaine about 10 minutes before sex each time and and I will continue this until I feel confortable without it. I think a lot of this is mentally training yourself that sex feels good again and your body is healed.

Sorry for the terrible writing... most times I'm blogging on the go from my phone with little or no proof reading. Thanks for reading!

Updates Post Vulvar Vestibulectomy Surgery 6 months

Hi Everyone! Sorry it's been so long since I have posted anything. I continued physical therapy until the end of April and since then have been too busy to continue. I now do some stretching exercises a few times a week using a latex glove and a little lidocaine gently stretching the vaginal opening. Sometimes sex is 90% or more painless!!! This is great! The new lidocaine gel prescription seems to be working much better than the old variety I was using. The best (most pain free)  time of the month seems to be a week after my period ends up until a week before it begins. After that it seems to be more painful and I'm not sure if that has to do with changing hormones or levels or discharge. I always put lidocaine on the irritated area at least 5 minutes before intercourse and I will just keep doing what I'm doing for now.  After another month or two of really pin pointing the days when I have the most pain during intercourse, I will bring it up with my obgyn at my annual. I am fully healed from surgery and there is no noticeable difference in the area. I also am staying away from birth control pills for now and have only been using condoms which works well for the time being.

Sorry I have not been responding to comments... I set it up so I am supposed to receive emails every time someone posts but it seems many of them are ending up in my spam folder. Thanks for reading and I will update as soon as anything changes.

Attempting Sex: Preparing for Intercourse After Vestibulectomy

Just another update. I encourage everyone to read my comment on the last post about addressing pain with physical therapy. So far it has really improved things along with recovering form surgery. I am excited to say that I had sex for the first time yesterday (since surgery) and it went really well. Still some pain with entry and a slight burning at times - but overall very good. I could really tell that my muscles were more relaxed. The area that I had removed with surgery was pain free! I just have some more internal burning that it getting better with PT. I am still going 2x a week and I am now using a size large dilator. The dilator hurts upon insertion but once it's in I feel nothing but mild stretching. Any friction with the dilator is somewhat painful though. I decided to get a size large so that I could be comfortable with something as large or maybe even a little larger than my boyfriend to make him seem smaller.

 I used a 3% lidocaine jelly that I had my pharmacist compound for me because the one that was originally prescribed for me was causing burning. I guess it was a combination of a high percentage (5%) and the base of the lidocaine cream that was causing the burning. I put about a dab about 2x the size of a pea just inside the opening (maybe 1-2 inches inside) from the 2pm to 11pm area. Then I use my figures to gently stretch open the area before intercourse. I wait about 5 minutes and I'm good to go. Make sure to use extra lube! I've found the lidocaine jelly actually works to let things slide easier. I also recommend "surgilube" which is a gentle option that my physical therapist uses. 

Comment and share your questions or experiences!

Addressing the Muscle Pain with Vulvar Vestibulitis

So I've been going to the physical therapist 2x a week for a few weeks now and I have noticed some improvement. I am now 98% pain free with the Q-tip test! Very exciting! And now I am moving on to continue addressing the muscle pain that I've been struggling with. I never realized that muscle pain causes burning the same way that the vestibulitis does. Now that the vestibule tissue is healed and practically pain free I can really identify the location of the muscle pain and it's just inside the vestibule area. The muscles feel so tight during PT and I can tell it is going to take a while to relax them and stretch out.  I try to use the dilators every other day and I am hoping to notice a difference in the next few weeks. If not, my next plan of action is botox which I have heard some women have had success with. The problem with that is you need to get injections every 4 months so I'd rather stick with PT and address the source of the problem. More updates soon! Thanks for reading!

Physical Therapy Update for Vestibulodynia

So I started physical therapy in week 8 and it was really encouraging. I was about 70-80% better with the q-tip test and my PT said this is totally normal because it should take 3 months to full heal. After she palpated the area I recognized some internal pain that I had not really felt before because it was masked by the much more sensitive external area before surgery. I felt a burning sensation and some pain in response to pressure. She told me that this is what muscle pain in this area feels like. It manifests itself as tightness but also burning in some situations too.

I used the sensor to test my muscles ability to contract and relax and did fairly well (much better than when I first went last spring). I bought a small+ dilator to start and am going to work my way up to a larger one.  You start by putting lubricant on the dilator (I found surgilube worked really well because is doesn't burn at all) and insert it into the vagina past where it starts to hurt and so that you feel a slight stretching or burning and leave it in for 10 minutes (I suggest using a pillow and a towel to keep it in so you don't have to hold it.) Then just relax your muscles and read a magazine or watch tv while you sit there with it inside. I am trying to do this 3-4 times a week in between my PT appointments which are once or twice a week.

6 to 8 Weeks Post Vulvar Vestibulectomy

It has now been almost 8 weeks since surgery. I had my 6 week check up about 10 days ago and everything is looking good. The 6 o clock area is still not full healed so my doctor told me to hold off on any stimulation to the area so I don't aggravate it. This means no sex... although the doctor did say oral sex was okay just nothing internal.  I don't have another scheduled appointment with my obgyn so now it's just a waiting game. I've been putting some calendula oil and aloe on the area to aid in healing. I don't have any discomfort doing normal every day activities. I do still have some swelling though; I notice it more when I wear tight pants and it is kind of like a bump on the outer labia that goes away after a while. I still soak in a sitz bath maybe once a week. I have an appointment with my pelvic floor physical therapist next week so hopefully that goes well. I'm a little nervous that the surgery hasn't full fixed my issue. I haven't been able to truly test the tenderness of the area yet but I will update again soon.

Thanks for reading as always!

Physical Therapy for Vulvar Vestibulitis

I started physical therapy for my vulvar vestibulitis about a year ago. This was one of the first things my 3rd obgyn had recommended to me. I got a good recommendation from her about a PT that has worked with patients like me frequently. I had to buy a special sensor that goes into the vaginal opening and measures how well your pelvic muscles tighten and relax. You lay on a comfortable table (like at the doctors) and flex and relax your pelvic muscles on command (basically doing kegels). Your muscle movements are tracked on a computer monitor which you can view afterwards. Then my PT worked on massaging the pelvic muscles both interior and exterior. My muscles were clearly very tight from guarding. Because sex was so painful, those muscles would tighten even thinking about it. I also learned about several different stretches that help my muscles relax. I went 2x a week for about 6 weeks and showed great success in my measured results with the sensor. I learned how to control my pelvic floor muscles and most importantly how to relax them to reduce pain. The only downfall was that I saw no difference in the pain I experienced during intercourse. I stopped going at the beginning of last summer but I plan to go again in two more weeks when I should be 95% recovered from surgery.

Sitz Baths for Post Surgery...

Sooo... it only took me about a week of doing sitz baths 3 times a day to realize that they were really uncomfortable. The cheap plastic ones are so hard and I felt like the bottoms of my thighs were getting bruised! I decided to look for alternatives and so I ended up buying a Soft Sitz.

This is an inflatable sitz bath that is really inexpensive. So much more comfortable than a traditional sitz bath! Although just to warn you it doesn't have any holes in the back to let out overflowing water and it doesn't come with a plastic bag and tube. I still find that it works well though. 

If you are interested, I bought it on Amazon here. 

One Week Post Surgery: Recovery and Walking

It's been just over a week since surgery and I'm doing really well. I'm so happy my period is over and I can finally go commando (recommended by my doctor) wearing comfy sweat pants when I'm around the house. This lets the area dry out to reduce the risk of infection. I'm still doing Sitz baths three times a day and using a blow dryer on low to dry the area after soaking. I have also been using the little squirt bottle the doctor gave me to rinse the area after going to the bathroom. The last few days have been totally pain free, although I haven't really had any real pain since the beginning. I can describe it more as being uncomfortable at times (or just kind of weird feeling). I've been going for walks, driving, and doing chores around the house with no issues. I still sit on a doughnut pillow when I do sit just to avoid putting any extra stress on the area. I also am really careful when bending down or getting in and out of the car so that I don't break open the stitches. The doctor said the stitches might cause a pokey feeling when I sit but I haven't really felt that. Maybe a little in the beginning when I was sitting down but not lately at all. I have my first post operation appointment this coming friday and I can't wait to tell my doctor how easy it's been. For anyone considering getting this surgery I would definitely recommend taking a week off afterwards where you can relax and let yourself heal but after that, as long as you have a doughnut pillow, things should be relatively normal. I am definitely not ready to go skiing, or biking, or even jogging necessarily, but I feel great.

Also, please remember that there are varying types of vulvar vestibulectomy's and depending on how much tissue was removed, there would be varying levels of pain. Some people have the vestibular glands removed and some do not. My particular surgery just removed the affected tissue on the surface and no glands were involved. I had the most pain at the 6pm spot of the vaginal opening but strong pain from the 2pm to the 10pm section.

More updates soon!

Day 4 Update: an unexpected pain...

Today was day 4 since my vulvar vestibulectomy. Yesterday was probably the worst day so far... I got my period and the cramps were unbearable. I took 2 ibuprofen at 8am and 2 midol at noon. This was more pain killers than I have taken for the surgery. It was also 10 times more painful, easily. I just sat in bed all day for the most part and did 3 sitz baths throughout the day.

Today was much better. The cramps were pretty much gone I just got a headache from my hormones acting up. I felt totally normal today. I still haven't really looked at the area because I'm too scared I'll tear the stitches. I also went for a walk today; going slow and taking it easy. It was nice to get out of the house and I had absolutely no pain. I used a doughnut pillow for the car ride but walking feels almost 100% normal; sometimes I feel the stitches poking into me though.

More updates soon :) comments or questions welcome.

Day 2 After My Vulvar Vestibulectomy

Today is the day after my surgery and it's going well for the most part. I didn't take any pain meds until about an hour ago which wasn't for vaginal pain but rather from back pain. Originally I thought I had slept weird and that was causing some stiffness but then I realized the back ache is probably from the spinal anesthesia. I looked at my back and saw the 2 injection spots which were just dots with no apparent bruising. The back pain started this morning and has gotten worse all day. I took one ibuprofen around 5pm and that has helped some. I hope it feels better by tomorrow. I have done 2 sitz baths so far today: one this morning when I woke up at noon and one around 6pm. I didn't use the bag and tube this time - just the bowl that you sit in and I added warm water from a cup as it cooled off. I noticed some more blood spotting but not much and I have no pain or soreness in the area. I walked around the house today a little and just made sure to take it really easy. I had a bowel movement and tried my best not to push at all. The stool softener definitely helped. Now I'm back in bed just relaxing and doing some reading. Sitting down is awkward but is definitely doable with a doughnut pillow. Since it's not painful, I'm just doing my best not to stretch anything or put any pressure on the area. My legs are still a little shaky but I'm hoping that goes away after a few days too.

Surgery Specifics (Illustration Included)

Vulvar Vestibulectomy Surgery
 Click Here for Image Source Website 

This is similar to the surgery that I had performed. The main difference for me is that the stitches are done individually rather than with one long string so that if one gets caught or pulled the rest aren't compromised. I also have dissolving stitches which don't have to be removed. I also didn't have the skin removed as high up by the urethra as in this image. I did from about 2 O'clock to 10 O'clock rather than 1 O'Clock to 11 O'clock. 

Getting ready for my Vulvar Vestibulectomy

Tomorrow is the big day. I am really nervous for the surgery itself and even more nervous that I'll do something to screw up the recovery. I haven't taken any medicine or vitamins all week and im going to clean my entire house this evening so that I can rest easy. I want to go to bed early so I'm well rested but I also want to eat t 11:30 pm because that's the last time I'll have a chance until tomorrow around 2pm. I usually get naucious when I don't eat but I'm hoping that's not the case tomorrow. My boyfriend will be at the hospital with me the entire time and I'm so glad he's there although he's only allowed to see me for 10 minutes during the 2 hours I sit in a recovery room directly after surgery. I bought a sitz bath and a big round doughnut pillow to use when I have to sit down. I'll post again tomorrow night after I get home or Saturday. Wish me luck!

Pre-op appointment - part 2

How long should the surgery take?
It's scheduled to take 1 hour and 15 mins but it should take less time than that.

How will I be sedated?
I can choose between a spinal where I can either be fully awake and numbed from the waste down or slightly drugged through an IV so I don't know what's going on while I'm numb from the waste down. My second option is to have a tube in my throat and be completely under anesthesia. My doctor recommended the spinal since I am young and healthy. I can decide the morning of the surgery when I speak to the anesthesiologist. The vestibule area will be numbed with a local anesthetic regardless.

How do I prepare for surgery?
I can't eat after 11:30pm the night before and I can only drink clear liquids until 4 hours before the surgery. I have to get to the hospital 2 hours before surgery is scheduled.

How long is recovery?
It should take a full 6 weeks before any stimulus should be applied to the area. At that point I will start going to the pelvic floor physical therapist weekly and gently massaging the area to stretch the skin.

What does the recovery process involve?
The first few days will be spent in bed or just walking around the house. After that I should take it easy for about a month with no strenuous exercise. Starting the evening I get home from surgery, I need to do a sitz bath 3x daily for up to a month. This involves soaking the affected area in luke warm water (with no soap) for about 30 minutes and then using a blow dryer with cool air to dry the area.

What is the risk of a recovery setback?
50% of patients break open the stitches which delays the healing process because the area now needs to close and heal on its own. This could push the recovery period back a few weeks. Straining when going to the bathroom or too much exercise can cause this as well.