Hmmm, well I don't think I would describe my experience this way (ie needing to stretch out before hand), but I will say that I am pretty sure I have be scar tissue that has impacted sex. I have had my pouch since I was 17, so I didn't have hardly any experience before I had my pouch, but I know that it took a long time (many years, well into my marriage) to figure out positions that were tolerable in terms of pressure on my pouch. If it is a new thing for you though then I would think it was not scar tissue. Overall I think my scar issues have gotten better with time.

I am going to see a pelvic floor physical therapist today. I hope this will help. I am pretty sure the scar tissue must be stretched out. I had to go years ago because I was having problems with stool leakage. At that time the PT told me I had a lot of scar tissue in the vaginal area too.

I found out that the pain is from the muscles.

Interesting.I have looks like gathered skin never noticed in that area. So far not causing any problems that I know but have wandered if it keeps getting closer/closer to vagina area what problems it will cause. I did have some issues of somewhat pain during sex.Not sure if it had to do w/bowels were attached to female area. I had pelvic floor rehab. for not being able to empty. Common for all women as get older. Surgery was in 2009 and so far no issue except seeing that shrivled looking skin. Going to ask dr. at my appt.