His and Her Health

Dr. Goldstein,

What types of treatments are available to patients who develop painful scar tissue from surgical procedures such as a vestibulectomy or episiotomy?

Does scar tissue always have to be surgical removed for a patient to have relief or can other methods such as steroid injections (into scar tissue) be tried first to reduce pain in this tissue?

Curious to know what treatments you find most effective in reducing scar tissue in your practice?

Usually stretching with vaginal dilators or physical therapy relieves most scar tissue, sometimes excision is required

<small>[ 10-04-2009, 10:41 PM: Message edited by: Moderator ]</small>

Hi,

For those of you who have had vestibulectomies and now have scar tissue, do you find that the scar tissue is easier to deal with than the vestibule pain? I guess what I'm asking is, does scar tissue feel like nerve pain or is it more of a dull pain? And does scar tissue interfere with sitting comfortably, wearing tight clothes, using tampons, etc.? (My vestibulitis constant nerve pain doesn't allow me to sit comfortably, wear tight clothes, use tampons, etc., so just trying to figure out if having surgery with the chance of ending up with scar tissue is worth it?)

Thanks

hey - you posted this awhile ago, so not sure if you are still wondering but...i had a partial vestibulectomy and ended up with very painful scar tissue. it wasn't as bad as the vesitibulitis but it was close to as bad. it made sex difficult and sitting too. i recently had a revision to remove the scar tissue and the rest of the vestibule.

that said, i do not think that most people end up with as much and as painful scar tissue as i did. but i guess it's a risk to be aware of. i was willing to take the risk to get it redone. i went to a different doctor this time.

Dear Honeyblue
Can you tell me please how I can identify if I have built scar tissue? because the scar i have from the vestibulectomy hurts really bad, although I'm now 11 weeks post-op. My doctor says everything's fine bit I got the impression he didn't really look at the scar.
Thanks very much, all kind of help is very much appreciated.

Suffering
Scar tissue if present may feel like a thickening of the tissue. It may or may not be painful, but usual will feel tough or harder. It may also be a little raised.
niva

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Many thanks to both of you for replying.
Nica, my scar feels and looks exactly as you describe it. What can I do except of massaging the scar? The scar alwyas hurts even worse after massaging it....:-/

Suffering, perhaps a warm compress or warm bath prior to massaging the area can help. Afterwards you can ice a little so the discomfort is minimized. Never put heat or ice directly on the skin.

Honeyblue, definitely dilators can help, but you may need more than the dilators. Have you tried physical therapy? Have you tried massaging the area yourself? Yes some people need to have the scar tissue removed, but I have not seen it many times happen this way.

best
niva

Dear Niva

Many thanks for the good ideas! How long will I have to do the massage? After how many weeks can I hope for improvement?

I've massaged it now for 4 weeks two times every day, until now it's not much better:-(

Suffering, well many applauses to you for being so dedicated to your recovery. Twice a day is wonderful. How are you massaging; are you using anything to massage the scar tissue. It may take 6 weeks to see something, but I would also think with your regular work that you would see some changes already. As for how long, well any amount of time you can spend is going to be helpful. I have patients start at a few minutes and work up to 5 or so minutes. This also dpends on the area size and their tolerance to the massage. Are you using dilators along with the massage?
niva

Thank you Niva. I haven't been using dilators because I don't feel narrow down there, I can stretch the entrance easily it's just the tissue that hurts. I don't seem to have any muscle problems...