How much granulation tissue in the neovaginal canal after penile inversion vaginoplasty prompts you to move from silver nitrate to operative excision?

There is no validated size cutoff for moving from silver nitrate to excision, so I decide on morphology, symptoms, and response rather than a measurement.

I observe small, flat, asymptomatic granulation tissue. Symptomatic tissue (bleeding, discharge, pain, or difficulty dilating) gets office silver ...