I've come to the final chapter of my 3 part series covering my surgery from 2017. This blog will detail the recovery period post operation and hopefully tie up any loose ends or questions you had looming about the overall experience.
If you haven't read blog 1 or 2 you'll want to do that 1st to make any sense out of this one. In my previous posts I explained what a Vestibulectomy is, why you'd want one, how to prepare for it, and what to expect at the hospital. Now I will detail what you can anticipate occurring once you've gone home, which is the part that feels the most intimidating to many people. I'll start by saying, follow whatever the doctor tells you. If she says not to look at your stitches then don't look at your stitches (I made the mistake of ignoring that advice!). I would assume the gyno you've selected to perform your surgery has done so at least a few handfuls of times, and knows what's best in terms of the way she goes about it, so trust her. Generally speaking, there are 2 set ways to do a Vestibulectomy, but if there is any variation in your doctor's method that affects the outcome she'll surely let you know.
Before getting released from the hospital (which should be shortly after the Vestibulectomy is complete) your surgeon will come inspect her work. If all looks well you'll be given notice that you are released and some items to take with when you discharge. I was given a giant water jug, which I love and still use to this day and special post partum underpants that are very stretchy and have no seam to rub up against you. Once you're ready, whomever is there with you may escort you down to the car. The 2 most important things to keep in mind as you leave are that you should not sit directly down on your stitches (you don't want to strain or rip them or cause yourself pain) and you can't walk up or down stairs for 6 weeks. Doing either of these activities could loosen or remove a stitch from its proper place and you don't want to have to go back in before your post op. Thus, make sure you have at least one donut pillow to sit on for the car ride home and an elevator to take down if you're on a higher level.
What do I do at home? Once home, you should have a bed set up where you pretty much plan to stay for the next couple of weeks. It's not that you won't be able to walk, you'll just be really tired and will find it easier to lay around than do anything else. You should have access to a TV, computer, books, or whatever chill entertainment appeals to you while lying down. You should also be near a bathroom with a bath and all of your meds you'll be taking throughout the day and night. Hopefully whatever bed you are able to stay in is comfy and make sure someone else is staying in the general vicinity with you in case you happen to need something you can get to. Motions you want to avoid: bending down, squatting, spreading your legs, sitting, running/jogging, or anything high impact. Don't plan to do laundry, exercise, or walk the dog. You basically want to only get up to go to the bathroom or get food. Hopefully some lovely friends or family will cook you some meals you can just heat up because you're not going to feel like cooking or preparing anything either.
How do I care for my vulva while it's healing? You can take up to 3 sitz baths a day (a shallow bath with epsom salt in it) where you carefully recline yourself against the back so you don't put pressure on the stitches, especially after a bowel movement. You should keep the area dry by gently patting it with toilet paper. You can wear the padsicles described in my last blog to catch any blood coming out and to soothe your vulva. As an alternative, you can also purchase Honey Pot Co's herbal pads, which have aloe, mint, and lavender essential oils in them to provide a cooling sensation, and come in several different sizes. These should be worn in loose fitting, larger underwear, like briefs or hipsters. Don't even think about wearing a thong or any material that could irritate your skin. You want 100% cotton, soft, stretchy, and roomy panties that you don't even notice while you're lounging around. Contact your doctor if you notice any puss, excessive bleeding, an odd smell, pain, or you develop a fever. These could be signs of an infection and not a normal part of the healing process. Refer to this PDF for more details.
How do I not dwell on my recovery and stay busy doing nothing? I actually spent hours every day on the phone to distract myself. I just so happened to have entered a new relationship so it was a great way for us to get to know each other because he worked from home and was off for a bit for the holiday (it was Thanksgiving weekend) so we had all of the time in the world to talk. Try to arrange for friends to come visit with you when they have a chance, even if just for half an hour. You don't want to get lonely and caught in your head about how things are going down there. It's also a good time to watch a series you've been considering trying out or take up some hobby you can do with your hands for a bit, like needlepoint or sewing. I love adult coloring books, but found that too difficult when I couldn't properly sit so I opted for lying in bed and singing along to music. I wanted to work on writing a song while stuck there, but didn't feel very creatively inspired while blitzed out of my head on meds.
When will things go back to normal? Everyone is different as far as how fast their body heals. I hadn't expected to start working half days from home on just my 2nd week out of the hospital, but that's how it went down for me. I was more alert than expected and didn't have to keep taking my heavy duty pain killers because I really wasn't having any pain. The worst pain I ever experienced was when I had my first bowel movement, several days after coming to my mom's house. I was taking stool softeners the whole time, but didn't know the nausea medication they prescribed me would further constipate me, so it took a long time to have to go and when I did it was excruciating. There was so much blood that I felt like I had started my period for the first time all over again. I panicked and called my mom over but she said it was fine and normal. I was really scared but eventually calmed down. I went back to my apt 2 weeks post op after I went to my first check in with the doctor. At that point she said everything was looking normal so I was free to go back to work. At the office I just moved very slowly and pretty much stayed at my desk. My coworkers knew I had surgery (just not what kind!) so I had someone assigned to help me out by warming up my lunch for me and bringing it to my desk, getting the mail, etc. so I didn't have to walk around too much. Then at 6 weeks I went to my final post op to see if my stitches had dissolved yet. Surprise, no they hadn't, but everything looked fine so I was told not to worry about it. I started having outercourse shortly after this point and began dilating again once I could see in a mirror that the stitches were completely gone. I chose not to touch my vulva with my hand at all during recovery, partially because you don't want to get germs there but also because I thought feeling it would freak me out. The mystery was better.
How long until I can have sex? This is obviously the most difficult question to answer. I won't lie to you, it took me almost a full year to be able to attempt PIV post surgery, from the end of Nov to the end of Aug. Dilating felt like completely starting over from scratch, back to the smallest size and working my way up to the big ones again. I was more confident this time around, since I'd gone through them all before, but it still took months to stretch my vagina back to where it was before. The ultimate question everyone always want to know is: was it worth it? I have a mixed response to that. In a word, yes, because I am able to have sex without pain now, but it's never that simple, is it?
As I mentioned in blog 1, you have a high chance of ending up with a Bartholin's Cyst if you get a full Vestibulectomy, which is what happened to me. I had done my research and recognized what it was immediately. Luckily I was already going in for a 3rd post op since my stitches had taken so long to dissolve so my doctor was able to see it for herself. I will never forget her reaction. "Oh, it's kinda cute. It looks like a grape." I did not appreciate this joke as it was already swelling up and growing, causing me pain when I sat down. I had waited SO long to be able to sit like a normal person again and now I had this bubble feeling like it could pop at any moment and blocking the entrance to my vagina, making dilating even more difficult. It also REALLY hurt during manual therapy as I did my required pelvic floor physical therapy to help stretch me back out. She told me it wasn't a big deal and it may go away on its own but it just kept growing. I wanted her to lance it but she said she could only do that if it was infected. It did go away randomly but came back even larger and it would swell up to epic proportions whenever I got turned on so it was hard for me to even want to orgasm. I just wanted to not feel pleasure at all so it would go down and relieve me of the pain. I ended up getting recommendations of some urogynecologists from my physical therapist and scheduled with them to have it lanced over the Christmas holiday, but they all told me that only the person who did my surgery could do it. So I left it alone and again, at some point during 2019, it just went away. I couldn't even tell you how many times it's resurfaced and dissipated again at this point. I've grown so used to re-emerging that I warn new partners about it, so they won't think it's a weird STD symptom, and I can sense the feeling of it trying to come back. Around 5 o'clock gets really swollen and will start to fill up. So I've just accepted it as another part of my broken body that I've come to think of as my little friend. Luckily mine has never gotten as large as the image below.
Only you can decide if getting a Vestibulectomy is the right choice for your body. I had a previous partner try to talk me out of doing it, which was really the nail in the coffin in me blocking him entirely and ridding him from my life. Your doctor can help guide you with the decision, but at the end of the day it's still up to you if going under the knife is in your best interest. I will tell you that having a brand new vulva that you don't recognize is hard to come to terms with. In one sense, it's like your born again, starting fresh, which is nice, but on the other side of that you have a brand new shape with more folds and many women say they feel like their vulva is "less pretty" after this change. I don't like the appearance of mine as much, but I actually do find the new shape to be better as it's more open and I think provides easier access. I will say that pre surgery I wasn't able to orgasm from oral (or PIV) and now I am, so I believe having my clit less buried has all around helped my sex life. I hope that's helpful to others considering a Vestibulectomy because the success rate is so hard to measure! It may pay off in 6 months, a year, or five, who knows! It just may be worth finding out.