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A Guide to SRS

Complications experienced from SRS

If you have information about your complications that you would like to share, please contact me so they can be added to this section.

Maddy’s experience with granulation tissue, perineal tear, and chronic labia minora pain.

Granulation

  • Appeared a few months following the operation
    • Located around the clitoris and her perineal tear
  • Dr Hart’s recommendation did not strike her as particularly helpful, being told that it may go down on its own or we can do a revision.
  • She then talked to her GP who suggested a topical steroid cream or if that fails cryotherapy to burn off the granulation tissue.
    • The topical steroid cream did not reduce the granulation. She instead had to get the granulation burnt off.
      • “Very painful process took me 8 weeks with two burning sessions a week. However, now it is completely gone with no new granulation 1.5 yrs later.”

Granulation started showing up a few months post op (appearing around clit and site of perineal tear), Kieran was not particularly helpful just said it may go down on its own or we can do revision. Talked to my gp who suggested a topical steroid cream or if that fails getting it burnt off with nitrogen. For me the topical steroid cream did nothing and I had to get it all burnt off. Very painful process took me 8 weeks with two burning sessions a week. However, now it is completely gone with no new granulation 1.5 yrs later.

Perineal (area between the vulva and anus) Tear

  • “This was extremely not fun. My partner at the time grabbed my bum too hard and tore my perineum (so listen to Naomi when she says be extremely careful about every movement).”
  • This tear caused urination and showering to become painful.
  • She had to stop dilating as it would reopen the tear.
  • The tear took approximately six months to heal.
    • Her recommendation is to reduce your dilator size until the injury heals, and failing that, cease dilating until the injury heals.

Perineal tear, this was extremely not fun. My partner at the time grabbed my bum too hard and tore my perineum (so listen to Naomi when she says be extremely careful about every movement). Getting the tear meant that it was very painful to pee / shower and I had to essentially stop dilating (as it would cause the tear to reopen). This took me about 6 months to heal, primary recommendations are stop dilating if it causes problems and up your salt bath frequency.

Chronic labia minora pain

  • “A near constant dull ache extending from under my right labia”
  • Consistent for 6 months post op, noticed a few weeks after surgery.
  • Pain would increase as she stood up, resulting in being unable to stand for longer than approximately 15 minutes at a time.
    • Reported that the pain was somewhat alleviated with compression on the area at the source of the pain.
  • The pain subsided after approximately 6 months for no apparent reason.

My experience with: Unidentifiable vaginal bleeding, urethral and interior vaginal webbing, excess spongiosal tissue, Chronic pain, painful arousal, and altered urination direction.

Vaginal bleeding

  • Started randomly in mid November 2024, ten months out from surgery
    • Continued until early May 2025 when I had my revision surgery.
  • Occured when I dilated, outside of dilation discharge was occasionally clear from blood
  • Was mainly a small amount that made my discharge pinkish with some very small blood clots
    • Occasionally there was a small amount of fresh blood when I’d dilate
  • No source of pain felt internally other than the feeling of discomfort from stretching internal tissue when dilating

Urethral / inner vaginal webbing (skin joining together where it isn’t supposed to) and altered urination direction

  • Occurred between my labia minora, covering my urethral opening.
    • This altered my urination direction up towards my stomach. This was inconvenient and resulted in some creative toilet positions
    • I initially thought something was wrong because the sound was wrong, instead of the higher pitched hiss it sounded lower.
      • As I was unsure of what the surgery was supposed to give me I brushed this off as something that was just the way the surgery went.
      • You can recognise this issue by their being no clear cleft between each labia minora. Also, by an unusual urination direction, velocity, and noise.
  • I was told during my revision that I had inner vaginal webbing
    • I have little information on this, other than that with it fixed dilation should now be easier
    • I thought this might have been the bulb of tissue i was feeling inside at the back of my vagina, but that is still there after the revision.
      • I am unsure what it is, my best guess is a “Peritoneal inclusion cyst/lymphocoele” listed in Dr Hart’s complications

Excess spongiosal tissue and painful arousal

  • The right labia minora was significantly larger than the left labia minora.
    • Dr Hart places spongiosal tissue under the labia minora for reasons unbeknownst to me, I imagine due to aesthetic or functional reasons
  • This tissue would when engorged cause me pain enough for me to avoid getting aroused.
    • It would also for some reason cause the same issue if I sat on the toilet, this was quite frustrating and inconvenient.
  • I believe it’s also connected to the chronic pain I’ve experienced

Chronic pain

  • A near constant dull ache extending from under my right labia down my right inner thigh.
    • consistent for the majority of time since surgery
    • My best guess at a cause is the ilioinguinal nerve being compressed, or something else of that nature.
  • My left leg and left side of my vulva are completely pain free, with no other issues.

Symptoms:

  1. If I wear clothing that is any kind of constrictive (underwear with elastic, jeans, etc.) the pain happens. I’ve had to start wearing exclusively loose fitting things
  2. If i sit the wrong way or cross my legs it hurts
  3. The only way to alleviate it is to lay down with my leg in a certain position (rotated outwards to the right)
  4. I had this rarely before surgery but after it it has been a daily occurrence and is getting pretty unbearable, and its degrading my quality of life

  • Dr Hart “sounds neural/musculoskeletal. Probably worth seeing a physio first up. Obviously will have a look when you are asleep, but unlikely to be anything to find that is reversible from my end.”

  • It is still ongoing (June 2025) after my revision surgery (May 2025)

    • However this may just be due to swelling in the area as a result of the excising of spongiosal tissue.
    • It now occurs even more when I’m laying down or sitting in my chair.
    • I spend a significant time just finding a position to sleep in that doesn’t cause me pain
    • If you have any idea of what may be causing this or how I could alleviate this pain, please contact me.
      • My current idea is physio, more healing time, or if it persists without improvement seeing another doctor.

Most of these issues have been resolved with my revision surgery (May 2025) bar the chronic pain (although it has improved somewhat). I occasionally get blood in my discharge still, but this may be due to the revision itself (June 2025).