Re: All Things DILATING

[Dr. Pacik]

How far do I push in the larger dilators?
The question comes up of how far the larger dilators need to be inserted. The pink #5 Pure Romance dilator is about an inch too long, and the large blue #6 of 6 is about 2 inches too long. The full length of the dilator hits the cervix which is not needed and is uncomfortable.
Most patients treated for vaginismus have spasm of the entry muscle. The other muscles do not demonstrate this severe spasm. When pushing in the dilator, if this is done slowly, and the Botox is not yet fully effective in the early aspects of treatment, one should notice resistance as the dilator is stretching the entry muscle. Once this muscle is passed, it is common to notice that the dilator suddenly “falls in” as there is no longer resistance higher up. When one is sensitive to this, it is easier to appreciate how far the dilator needs to be inserted.