{{Short description|Medical instrument used to stretch the vagina}} [[File:Plastic and Silicone vaginal dilators.jpg|thumb|upright|Plastic and silicone vaginal dilators]] [[File:Inflatable vaginal expander.jpg|thumb|upright|ZSI 200 NS vaginal expander]] A '''vaginal dilator''', sometimes called a '''vaginal trainer''', '''vaginal stent''' or '''vaginal expander''',<ref>{{cite web|url=http://www.nhs.uk/Conditions/Vaginismus/Pages/Treatment.aspx|title=Vaginismus|date=11 January 2018|publisher=[[National Health Service]]|access-date=2020-02-29|archive-date=2017-10-13|archive-url=https://web.archive.org/web/20171013154528/http://www.nhs.uk/Conditions/Vaginismus/Pages/Treatment.aspx}}</ref> is an instrument used to gently stretch the [[vagina]]. They are used when the vagina has become narrowed ([[vaginal stenosis]]), such as after [[brachytherapy]] for gynecologic cancers,<ref name=Cochrane>{{cite journal |last1=Miles |first1=Tracie |last2=Johnson |first2=Neal |title=Vaginal dilator therapy for women receiving pelvic radiotherapy |journal=Cochrane Database Syst Rev |volume=9 |issue= 9|article-number=CD007291 |year=2014 |pmid=25198150 |doi=10.1002/14651858.CD007291.pub3 |pmc=6513398 }}</ref> as therapy for [[vaginismus]] and other forms of [[dyspareunia]],<ref>{{cite journal|first1=T. O. |last1=Idama |first2=D. W. |last2=Pring |title=Vaginal dilator therapy-an outpatient gynaecological option in the management of dyspareunia |journal=Journal of Obstetrics and Gynaecology |volume=20 |year=2000 |issue=3 |pages=303–05 |doi=10.1080/01443610050009683 |pmid = 15512559|s2cid=218856132 }}</ref> and to maintain the [[neovaginal canal]] following [[gender-affirming surgery]].<ref name="Bene-Et-al-2024">{{cite journal |last1=Bene |first1=Nicholas C. |last2=Ferrin |first2=Peter C. |last3=Xu |first3=Jing |last4=Dy |first4=Geolani W. |last5=Dugi |first5=Daniel |last6=Peters |first6=Blair R. |title=Tissue Options for Construction of the Neovaginal Canal in Gender-Affirming Vaginoplasty |journal=[[Journal of Clinical Medicine]] |date=8 May 2024 |volume=13 |issue=10 |page=2760 |doi=10.3390/jcm13102760 |pmid=38792302 |pmc=11122258 |doi-access=free |language=en |issn=2077-0383}}</ref>
There is evidence for dilator use across many different diagnoses with fair to good results.<ref>{{cite web|url=https://www.intimaterose.com/pages/frequently-asked-questions-vaginal-dilators/|title=Frequently Asked Questions - Vaginal Dilators FAQ|first=Amanda|last=Olson|website=Intimate Rose}}</ref> This includes following [[cancer treatment]]s and for [[vaginal agenesis]] conditions. The evidence presents varying approaches and protocols.
Vaginal dilators, can be solid or inflatable and are commonly used during surgeries.<ref>{{cite journal |last1=Coskun |first1=Ayhan |last2=Coban |first2=Yusuf Kenan |last3=Vardar |first3=Mehmet Ali |last4=Dalay |first4=Ahmet Cemil |title=The use of a silicone-coated acrylic vaginal stent in McIndoe vaginoplasty and review of the literature concerning silicone-based vaginal stents: a case report |journal=BMC Surgery |date=10 July 2007 |volume=7 |issue=1 |page=13 | pmc=1947946| doi=10.1186/1471-2482-7-13|pmid=17623058 |doi-access=free }}</ref><ref>{{cite journal |last1=Barutçu |first1=Ali |last2=Akgüner |first2=Muharrem |title=McIndoe Vaginoplasty with the Inflatable Vaginal Stent |journal=Annals of Plastic Surgery |date=November 1998 |volume=41 |issue=5 |pages=568–569 |doi=10.1097/00000637-199811000-00020|pmid=9827964 }}</ref><ref name="PPTRobotic">{{cite journal |last1=Dy |first1=Geolani W. |last2=Jun |first2=Min Suk |last3=Blasdel |first3=Gaines |last4=Bluebond-Langner |first4=Rachel |last5=Zhao |first5=Lee C. |title=Outcomes of Gender Affirming Peritoneal Flap Vaginoplasty Using the Da Vinci Single Port Versus Xi Robotic Systems |journal=[[European Urology]] |date=1 May 2021 |volume=79 |issue=5 |pages=676–683 |doi=10.1016/j.eururo.2020.06.040 |pmid=32624272 |url=https://www.sciencedirect.com/science/article/abs/pii/S0302283820304693 |access-date=31 August 2025 |issn=0302-2838|url-access=subscription }}</ref> Vaginal stents are routinely used in surgery and postoperative care for [[transgender women]] who are undergoing gender-affirming vaginoplasty to form a neovagina.<ref name="PPTRobotic"/><ref name="Bene-Et-al-2024"/><ref name="Hopkins">{{cite web |last1=Liang |first1=Fan |last2=Cohen |first2=Andrew |title=Vaginoplasty for Gender Affirmation |url=https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/vaginoplasty-for-gender-affirmation |website=[[Johns Hopkins Center for Transgender and Gender Expansive Health]] |access-date=31 August 2025 |language=en}}</ref><ref name="Spanish">{{cite journal |last1=Antoniadis |first1=N |last2=Charles |first2=G |last3=Mejías |first3=I |last4=Pabón |first4=R |title=Vaginoplastia: modificación de la técnica de McIndoe usando esponja de gel hemostático|trans-title=Vaginoplasty: modification to McIndoe {{sic|nolink=y|reason=error in source|techique}} using hemostatic gel sponge |journal=Cirugía Plástica Ibero-Latinoamericana |date=March 2011 |volume=37 |issue=1 |pages=73–77 |doi=10.4321/S0376-78922011000100010 |url=http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0376-78922011000100010|doi-access=free }}</ref> The vaginal expander is used immediately after surgery to keep the passage from collapsing, and regularly thereafter to maintain the viability of the [[neovagina]]. Frequency of use requirements decrease over time, but remains obligatory lifelong.<ref name="Rinzler-2010">{{cite book |last=Rinzler |first=Carol Ann |title=The Encyclopedia of Cosmetic and Plastic Surgery |url=https://books.google.com/books?id=N5nWmFCbYqcC&pg=PA195 |series=Facts on File library of health and living. |date=12 May 2010 |publisher=Infobase Publishing |location=New York |isbn=978-1-4381-2702-6 |page=195 |oclc=223107099 |access-date=31 May 2018}}</ref><ref name="Georgiade-1992">{{cite book |last1=Georgiade |first1=Gregory S. |last2=Georgiade |first2=Nicholas G. |title=Textbook of plastic, maxillofacial, and reconstructive surgery |url=https://books.google.com/books?id=snJsAAAAMAAJ |year=1992 |publisher=Williams & Wilkins |location=Baltimore, Maryland |isbn=978-0-683-03454-7 |oclc=455225627 |access-date=31 May 2018}}</ref>
==Use== With solid vaginal dilators, the patient starts with the smallest dilator size, then gradually increasing until the largest dilator size is reached. This practice can be accompanied by breathing exercises in order to relax the pelvic floor muscles. Dilation acts should not cause pain or bleeding.<ref>{{cite web |last1=Psychosexual Team, Oxfordshire Sexual Health Service |title=Vaginal Dilator Exercises for Psychosexual Therapy |url=https://www.ouh.nhs.uk/patient-guide/leaflets/files/30804Pexercises.pdf |publisher=Oxford University Hospitals NHS Foundation Trust}}</ref> Dilatation with rigid dilators must be done carefully as vaginal perforation and urethral injury may occur.<ref>{{cite journal |last1=HOFFMAN |first1=M |title=Risks of rigid dilation for a radiated vaginal cuff: two related rectovaginal fistulas |journal=Obstetrics & Gynecology |date=May 2003 |volume=101 |issue=5 |pages=1125–1126 |doi=10.1016/s0029-7844(02)02624-8|pmid=12738124 |s2cid=40647600 }}</ref><ref>{{cite journal |last1=Lue |first1=Kathy |last2=Heinsimer |first2=Kevin |last3=Madiraju |first3=SriGita K. |last4=Rideout |first4=Drew |last5=Wiegand |first5=Lucas |title=Urologic trauma from vaginal dilation for congenital vaginal stenosis: A newly-described and challenging complication |journal=Urology Case Reports |date=January 2020 |volume=28 |article-number=101075 |doi=10.1016/j.eucr.2019.101075 |pmid=31788430 |pmc=6880012 |doi-access=free }}</ref> There is no consensus on the frequency and duration of using vaginal dilators.<ref>{{cite journal |last1=Liu |first1=Marisa |last2=Juravic |first2=Mark |last3=Mazza |first3=Genevieve |last4=Krychman |first4=Michael L. |title=Vaginal Dilators: Issues and Answers |journal=Sexual Medicine Reviews |date=January 2020 |volume=9 |issue=2 |pages=212–220 |doi=10.1016/j.sxmr.2019.11.005|pmid=32014450 |s2cid=211026055 }}</ref> In case of vaginal expanders, the therapist or the patient introduces the deflated balloon into the vagina and then inflates it gently until the required diameter is obtained.<ref name="Spanish" />
Following [[gender-affirming vaginoplasty]], patients may be required to use vaginal dilators multiple times daily to maintain the depth and length of the neovagina. Different size dilators may be used, typically starting with a smaller diameter and increasing the size over the course of several weeks post-surgery. Over time the frequency of dilation can be reduced to daily and eventually to every few days as instructed by surgeons.<ref name="PPTRobotic"/><ref name="Bene-Et-al-2024"/><ref name="Hopkins"/>
== Image gallery == {{multiple image | perrow = 2 | align = center | image1 = ZSI 200 NS Vaginal Expander in Vagina.jpg | width1 = 250 | alt1 = | link1 = | caption1 = | image2 = ZSI 200 NS Vaginal Expander in Neovagina.jpg | width2 = 250 | alt2 = | link2 = | caption2 = | footer = Diagrams of ZSI 200 NS vaginal expanders placed in the natal vagina (left) and in the neovagina after [[vaginoplasty]] (right) }}
== In popular culture == Vaginal dilators appear in the comedy feature film ''[https://ladypartsfilm.com/ Lady Parts]'', as the main character struggles with [[vaginismus]] after receiving a [[vestibulectomy]].<ref>{{Cite web |title=Lady Parts Film Trailer |url=https://www.intimaterose.com/pages/lady-parts-film-trailer |access-date=2024-04-26 |website=Intimate Rose |language=en}}</ref> They are also a major feature of the film ''[[Fitting In]]'' where the main character is advised to use them after being diagnosed with [[MRKH syndrome]].
==See also== * [[Dilator (medical instrument)]] * [[Dildo]] * [[Rectal dilator]] * [[Vaginoplasty]]
==References== {{Reflist}}
[[Category:Gynaecology]] [[Category:Medical equipment]]