Dilators, Pelvic Floor Physio and Gender-affirming surgery

Gender-affirming surgery or Gender Confirmation Surgery is an important aspect of gender transition for many individuals. For individuals undergoing procedures such as vaginoplasty, pelvic floor physiotherapy and dilators play a crucial role in post-operative care. 

What is gender-affirming surgery?

Gender-affirming surgery, also known as gender confirmation surgery, refers to surgical procedures that help individuals transition physically to their identified gender. These surgeries can include procedures such as vaginoplasty, phalloplasty, chest reconstruction (mastectomy or breast augmentation), and facial feminisation or masculinisation surgeries. For those transitioning from male to female (MtF) a procedure known as vaginoplasty is performed to create a neo-vagina. In this case vaginal dilation is an essential part of post-surgical care to prevent the new vaginal canal from shortening or narrowing. 

How does pelvic floor physiotherapy help post-gender-affirming surgery?

Pelvic floor physiotherapy is essential post-gender-affirming surgery, particularly for procedures involving the creation of a neovagina. Physiotherapists specialised in pelvic floor rehabilitation can assist with optimising pelvic floor function, promoting healing, reducing pain, and addressing any post-operative complications. They are also pivotal in guiding individuals about how often and when to use dilators.  

What role do dilators play in post-operative care?

Dilators are often prescribed post-gender-affirming surgery to maintain or increase the depth and width of the neovagina. Dilator therapy helps prevent vaginal stenosis (narrowing) and promotes tissue flexibility and elasticity. Clients often find that using softer Medical Grade Silicone Dilators are preferable to the hard plastic dilators often provided from the surgeon. Dilators are typically used daily as per your post-op instructions under the guidance of a pelvic floor physiotherapist to achieve optimal results.

How do dilators work post-surgery?

After gender-affirming surgery, dilators are used to maintain the depth and width of the neovagina. Dilator therapy typically begins a few weeks after surgery once the initial healing phase is complete. The process involves gradually inserting dilators of increasing size into the vaginal canal to stretch the tissues and prevent scarring or narrowing.

Using dilators post-surgery requires patience, consistency, and guidance from a pelvic floor physiotherapist. Dilator therapy sessions will start with smaller-sized dilators and progress to larger sizes over time. It's essential to follow the recommended schedule and techniques provided by your physiotherapist to achieve optimal outcomes.


How do I find a qualified pelvic floor physiotherapist for post-operative care?

It's crucial to work with a pelvic floor physiotherapist experienced in treating individuals undergoing gender-affirming surgery. You can use our practitioner locator to find a qualified physiotherapist in your area who can provide specialised care tailored to your needs.

What should I expect during pelvic floor physiotherapy sessions post-surgery?

During pelvic floor physiotherapy sessions, your physiotherapist will conduct a comprehensive assessment of your pelvic floor muscles and overall function. Treatment may include manual therapy techniques, exercises to improve muscle strength and coordination, education on dilator use, and guidance on post-operative self-care.

Pelvic floor physiotherapy and dilator therapy play integral roles in post-operative care for individuals undergoing gender-affirming surgery. Working with a qualified pelvic floor physiotherapist can help optimize recovery, promote tissue health, and enhance overall well-being throughout the transition process. 

Learn more about our collection of vaginal dilators.