Informative leaflet about neovaginal dilatation after MtF reassignment surgery: the importance of correct management of dilatation programme

Objectives: To provide a valid guideline for an effective dilatation in MtF patients who underwent vaginal reconstructive surgery. Materials and Methods: Dilatation Informative Leaflet is composed by 5 parts: description of dilatators (with photos), setting, performance, behavioral aspects, psychosexual aspects. Figures show three positions suggested to perform a correct dilatation. Vaginal dilatators have different sizes (lenght cm x diameter cm): 9x2cm, 11x2.5cm, 14x3cm,16x3,5cm. We submit the Dilatation Informative Leaflet to all patients at first medical examination in order to give them the adequate time to read it toghether with the surgeon and understand it completely before surgery. Patients are partnered by the surgeon and the dedicate nurse for the first dilatation (3th-4th Day after surgery), then they are usually able to do it individually. For the first 6 months after surgery we suggest to do 3-4 dilatations daily, then almost twice daily lifetime. Results: Pre-operative knowledge of dilatation management allows patients to learn the best technique briefly and start functional rehabilitation of neovagina shortly after surgery. Conclusion: Dilatation of neovagina has crucial role after sex reassignment surgery in MtF patients. A proper dilatation technique guarantees an adequate depth and diameter of neovagina and prevents from scar stenosis. Understanding the importance of correct management of dilatations plays a central role in sexual health for subjects who underwent sex reassignment surgery.