Dilation Schedule & Strategy

During my research into SRS, I have come across different charts that are provided by different surgeons to their patients on how to dilate. These schedules go week by week telling the patient what to do. Unfortunately when it comes to Mount Sinai hospital, I was not provided any schedule and simply go by what I'm told by the doctors at my follow-up appointments. Leveling up in dilator size  is at this point "as tolerated" and depends entirely on how I feel. Well that didn't help much now that I'm in a transition period between using the smaller purple dilator and the larger blue dilator. I accidentally ripped the vaginal canal trying to insert the blue dilator all the way in. I didn't even know I had torn anything. It was very minor and only noticed when I removed the blue dilator when I was done and saw blood on it. So I think it might be helpful to others seeking surgery to share how I go about dilating.

For those who don't know what dilating is, please go back to older blog posts about dilation. Here's a link to a photo of my vaginal dilators: https://i.imgur.com/ndD8v1V.jpg

Dilating is an all day thing basically. Once you get up to having to do it three or four times a day, it almost feels tedious. A typical dilation session will last 30-50 minutes from preparation to clean up. I've put together a dilation bag which contains all the supplies I'll need for dilating. It keeps things simple having it all together in one place to just grab, lay down and set it all up. Dilation can be messy. The dilator begins to feel a bit more loose in the vagina after about four or five days after beginning the next size up. The initial skin tightness relaxes.

Dilation requires:
-Tissues or toilet paper
-Paper towels
-A bath towel (optional)
-Water-based plain lubricant (KY or WET is recommended)
-Dilator set
-A good sized hand-held mirror
-A flashlight (optional)

A bath towel can help keep your bed sheets protected from any spilled lubes, blood or fluids. Layering up a bunch of paper towels and sitting on them to catch stuff is good too. A flashlight is something I like having to inspect myself at least once day while I'm healing to make sure there are no signs of infection, irritation, cuts or other problems. Being proactive in your recovery can save you a lot of trouble in the future by catching complications early. The mirror helps you see what you're doing during self inspection and during cleanup. Tweezers are also helpful early on to pick out sutures that have dissolved and are falling out.

My Dilation Schedule

Week One:
-No Dilation
-Wound Vac, Foley Catheter & Vaginal Packing are still in

Week Two:
-Purple dilator, full depth (Dot 5)
-Once a day, preferably twice a day
-20 minutes minimum

Week Three:
-Purple dilator, full depth (Dot 4)
-Twice a day (10am, 10pm)
-20 minutes minimum, 30 minutes as tolerated

Week Four:
-Purple dilator, full depth (Dot 4)
-Three times a day (9am, 4pm, 10pm)
-20 minutes minimum, 30 minutes as tolerated

Weeks 5 - 8:
-Purple dilator, full depth (Dot 4)
-Three times a day
-30 minutes

Four Week Long Size-Up Transition Period (Purple To Blue)

Week Nine:
-Three times a day (9am, 4pm, 10pm)
-Purple dilator, full depth for 30 minutes
-Blue dilator, dot 2 to dot 2.5 as tolerated, 10 minutes

Week Ten:
-Three times a day
-Purple dilator, full depth for 20 minutes
-Blue dilator, dot 3 to dot 3.5 as tolerated, 15 minutes

Week Eleven:
-Three times a day
-Purple dilator, full depth for 10 minutes
-Blue dilator, dot 3.5 to full depth as tolerated, 20 minutes

Week Twelve:
-Three times a day
-Purple dilator, full depth for 3-5 minutes (warm-up stretch)
-Blue dilator, full depth, 30 minutes

Blue Dilator

Week Thirteen:
-Three times a day
-Purple dilator, full depth for 3-5 minutes (warm-up stretch)
-Blue dilator, full depth, 30 minutes

Week Fourteen:
-Three times a day
-Purple dilator, full depth for 3-5 minutes (warm-up stretch)
-Blue dilator, full depth, 30 minutes

Weeks 15+:
-Blue dilator, full depth
-Three times a day
-30 minutes

I have updated this as of Week 24. The schedule may change based on my recovery, how I feel and how dilation progresses as a result. I will update this accordingly. This is a very careful, light stress on the vagina type of scheduling. I noticed that already five days into Week Nine's dilation I was at 2.5 to 3 dots and fairly loosened. The first few days in particular the bigger dilator had to be carefully, gently pulled out because of how tight and sticky it was. For at least the first 3 or 4 months post op, it's best to take the safe and gentle route but perhaps later on the dilation progress can speed up.

UPDATE: On Week 20 I began to level up to the next size dilator, the green. After a month, the green dilator has seen little progress as of Week 24. Unlike the blue dilator which reached full depth in less than a month, the green has only progressed mere millimeters. I am unsure if I will be capable of fitting the green dilator and will have to discuss this with the surgeon.