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Had Surgery Yesterday for Vaginal Stenosis and I'm l'm Probably More Frustrated Than Relieved!

cujuja4evr
Posts: 106
Joined: Jul 2010

I had surgery for vaginal stenosis yesterday morning. Surgery seemed to have gone well, but all the other stuff is making me so frustrated I could cry. Onc Gyn managed to removed scar tissue which seemed to have completely blocked the opening, HOWEVER, it disturbed all areas around anus which had FINALLY healed up! Once again, I'm back to painful BMs, bleeding, soreness, and the works! It seemed so long to get to the point of somewhat feeling normal again and now the nightmare has returned!

Not only that, but Onc Gyn gave me a medium and large-size vaginal dialator. The medium dialator is like trying to insert a baseball bat through a hole the size of a green pea. I was told to insert the dialator to the point of pressure, not pain...hold for 10 seconds and release. Wait a few moments and repeat about 10 times. As soon as I start to insert, I immediately feel pain. Dialator is waaaaaaaay to big! I was given an estrogen cream to insert at bedtime for the next 4 weeks and the applicator can barely fit and the applicator is narrower than my pinky finger! It took a long time just to insert it and when I removed it, I was in so much pain I was miserable.

I called the doctor's office twice today and I never received a call back. Now I'm afraid of having a BM. I didn't have one yesterday. I passed a very small stool this morning, but as soon as I felt the burning, I stopped myself from going any further. Now, my stomach is cramping and I know sooner or later I'll have to go to use the bathroom.

I guess I'll have to go back to some of the advice that I've been giving others and try to pass my stools in a very warm sitz bath to ease some of the pain. I've been applying aquaphor throughout the days. I think I may have a fissure because the surgery may have torn some of the skin inside and around the anus.

I'll be glad when this is finally over...or is it ever going to be over???

I'm so frustrated at the moment. Just had to vent!

Judy

mp327's picture
mp327
Posts: 2939
Joined: Jan 2010

I'm sorry you are so frustrated right now. It's like one step forwards, three steps back. I had made good progress with dilator use and had been able to go up one size, that is until my May PET scan showed activity in my upper vagina, thought to be inflammation. So as not to cause anymore damage, I quit using the dilator until I had the follow-up scan in late July. Luckily, the vaginal activity was gone, but then I had to start all over with the smaller dilator and have not been able to use the bigger one yet. As for the BM's or lack thereof, make sure you drink plenty of water and you might want to begin using a stool softener. I just recently began using Dulcolax (not the laxative) and it is helping to make my BM's much more comfortable. I started with one pill a day, but am now up to the max dose of 3 per day and have noticeable improvement. I was having a lot of pain with BM's, bleeding and soreness that never seemed to go away. Things are much better now! I know this is discouraging, but please don't give up.

z's picture
z
Posts: 1257
Joined: May 2009

Hi Judy,

I'm sorry your having such issues. I know how you feel about finally the anal area healing and now this that caused irritation. I know my oncologist did a dre and it caused the perianal area to bleed, as the skin is so thin. could you possibly use your fingers to try to stretch the area on a daily basis, I know the dialators are hard plastic and your fingers would be more gentle. Of course use lots of lubricant. I had to use the estrogen cream for a while and it really helped toughen up my skin and ease the pain. I hope that this will get better for you each and every day. Lori

cujuja4evr
Posts: 106
Joined: Jul 2010

I know at this point that there is nothing much to do, but grin and bear it. I just have to go back to sitz bath, aquaphor, and everything else I did to relieve pain and suffering. It is like one step forward, three steps back, but I made it through before and I'll have to do it again. What is a dre and what does the doctor do? It sounds like it's a painful process like we need more pain than we've already endured, right?

My perianal area is swollen and the skin around the anus has definitely been irritated because I feel the burning when I urinate and the urine splashes on that area.

I just look forward to getting better.

Thanks for your encouragement and suggestions. I appreciate you more than you may know.

cujuja4evr
Posts: 106
Joined: Jul 2010

I haven't been on the board in a while because I began to get depressed and I found myself venting more than encouraging others. I have been very frustrated with my care team. I had a consult with my onc and when I began explaining my concerns, he just turned away from me while I was talking and started typing on the computer. He then said, "I'm going to print out the national guidelines so that you will see that we aren't making this up as we go along." When he said that I felt that I was alone in this battle. It seemed like the onc was more concerned about covering his butt and the rad's butt. He tried to tell me that since my tumor was 2cm and it was caught early, scans are not even required...So, I guess I won't be getting any scans now or ever. I'll be questioning everything for as long as I live. I know I should just be positive and believe that the tumor is gone and that should be good enough. I hate this feeling of "not knowing". I have gone through so much pain, agony, and suffering and I still don't feel that it was all worth it because I really don't know if it worked. I now have a lump the size of a peanut M&M behind my right ear. My husband discovered it a couple of days ago and now that's just one more thing to be worried about.

As far as my onc gyn, she apparently is close personal friends with my onc and onc gyn was very nonchalant about the whole issue of vaginal stenosis and said she basically agreed with my rad and NOT with my gyn. I'm so confused over this whole thing. My vaginal canal seems smaller than it has ever been. I cried last night trying to insert applicator with estrogen cream because it took forever to go in (even with KY Jelly) and it was painful.

But, I'll be dam**d if I'm going to give up. I have to take a proactive approach to this thing because it doesn't benefit anyone else but me and my family. The care team are getting paid anyway so what difference does it make to them. I called the doctor's office twice yesterday because I was having problems following my surgery and I haven't received a call back yet. It's so nice to know that they care! I called my insurance company to see if they will cover the cost of a vaginal dialator set I saw online and they said I just need to give them a procedure number and they could look it up. Even if they don't pay for it, I don't care...I'm getting it anyway and I'll just have to do this on my own.

I do thank you and others on this board because you make me feel human. It's nice to know that there are others who are willing to listen and provide suggestions to help me in my journey. Thanks again.

z's picture
z
Posts: 1257
Joined: May 2009

A DRE is a digital rectal exam, and when the onco did it it I could feel the pressure up to the rectum, which is the proper way to check for any growth. I think that even if the tumor was 2 mm after tx you should still be scanned. I think that the guidelines will tell you for certain. I am just upset they didn't give you dialators from the radiologists, after your tx was complete. I received dialators from the radiologists, right after tx was done. I used the dialator about twice a week, but when I took my shower I would use my fingers as that was more gentle and I could control the pressure better. I had a paps smear this year and the gyno PA was able to access my ovarys, so I know what I did worked. I still use the dialator and I need to start using my fingers again. I know the estrogen cream really helped me, as I don't have to use it as often, only when I get really dry. I know you won't give up, and this is certainly the place to vent. Lori

lemonade
Posts: 62
Joined: Feb 2010

Just for your information - I got my dilator set on Amazon.com of all places. I was googling where to buy one and there it was. It is endorsed/made by Dr. Laura Berman and it cost about $50 I think. She had a couple of different ones on the website.

Barbara

ranelle65
Posts: 63
Joined: Jul 2010

I was talking to my husband about all this, along with the challenges I'm facing today and he is discouraged. I think when I talk to my gyn dr on monday afternoon, I'll ask for her advise to re-dilate the vagina with minimal pain.

tiny one
Posts: 467
Joined: Jan 2009

I have found the following to be helpful for me, it may help you. Astroglide works well for me. Start out with your small dilator, use lots of astroglide. I put a massager in the pubic area to help relax. Then I use the next size dilator. After I've been using replens every three days. I've been not feeling any irritation since using replens. I had narrowing after radiation and have not been using a dilator. I had an ileostomy reversal and had alot of frequency, pain and soreness. I was in alot of pain and didn't want to even attempt to feel more discomfort. I hope you start feeling better soon.

ranelle65
Posts: 63
Joined: Jul 2010

What is an ileostomy reversal?

tiny one
Posts: 467
Joined: Jan 2009

An ileostomy is similar to a colostomy. It is a part of intestine brought to the outside of the body, this is called a stoma. Basically the waste goes into a bag and has to be emptied periodically. Reversal is the surgery to connect the intestine back to start going to the bathroom normal again.

Ladymaule
Posts: 3
Joined: Oct 2011

I had stenosis and had to have surgery in march this year and unfortunately I am back to square one and have to go back to theatre
How are you gettin on ?

Ladymaule
Posts: 3
Joined: Oct 2011

I had stenosis and had to have surgery in march this year and unfortunately I am back to square one and have to go back to theatre
How are you gettin on ?

Memphis Mary 49's picture
Memphis Mary 49
Posts: 52
Joined: Aug 2011

Judy,

I can definitely relate to the baseball bat through the green pea hole! That is just how I felt when I tried to use the medium sized dilator that my rad onc gave me. I thought he must be joking! I had my first appointment with my gyn onc about 10 days ago (I'm 9.5 weeks out from treatment). I would love to share the protocol that she gave me. It is working for me. I can now get the medium sized dilator in with minimal discomfort and concentrating on relaxing.

"Post Radiation Vaginal Stenosis Protocol"

1. Apply Premarin cream, 1/3 of applicator, inside the vagina every other day. Save a little to use on the vulva.
2. Alternate steroid cream (prescription strength) with hormone cream every other day. Apply to vulva.
3. Apply unflavored Crisco shortening to the vulva once or twice a day to prevent drying and cracking. (She said it works better that other ointments)
4. Once or twice a day, either you or your partner needs to put xylocaine jelly (prescription topical anesthetic) on your finger and insert finger into the vagina. Put pressure downwards, towards the anus, to massage this muscle. Advance finger into the vagina and massage the inside to dilate.
5. As you heal and as your vagina becomes less tense, you can use dilators of increasing size to continue stretching the vagina.

This seems to be working for me. I started out with the smallest vaginal dilator offered by http://www.soulsourceenterprises.com/. Their silicone dilators really are the best because they are pliable and not rigid. The main key for me is that I coat the dilator with the xylocaine jelly and gently and slowly insert the dilator. The numbing action of the xylocaine jelly is what allows me to advance the dilator. I can now get the medium one in about 4 inches or so. I move the dilator in a circular fashion to massage that muscle at the opening where it is the tightest. My husband (always my bright spot) has suggested, "maybe I should put the xylocaine on my penis..." He makes me laugh!

As far as BMs, I take miralax (generic) every day. If I do not have a BM each day, I also take one senna in addition to the mirlax the next day. I pay attention to keeping the BMs soft enough to not cause pain.

I hope that there is something in my reply that may help you. Let me know if it does, or if you have questions. I'm still learning too!

Wishing you great success!
Mary

By the way, I paid for the dilator out of pocket. It was worth it to me to not hassle with insurance over a $20 item.

sandysp's picture
sandysp
Posts: 798
Joined: May 2011

I am aghast at all this. My Radiologist gave me a dialator packet with all sizes and lubricant on the first visit and told me to use it twice a week all through treatment. Because I had been on this site I recognized that this was important. It may be because of the location of the tumor - mine was south rather than north, but I have not yet had any urination symptoms.

As far as BM's that's another story. My doctor recommended Colace (I was taking Ducolax) and I can tell you it's a much better product. Solved my problem - I take up to six a day religiously.

I would be very frustrated and be looking around for better care if in your situation right now.

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