My major problem was that my labia minora was fused, and the urine tunneled under it to exit at the vaginal opening. This resulted in constant pain and inflammation. I have some kind of vaginal fusing, but only the lower section of my vagina is fused, I have an opening depth of about 2 -3 inches left. Because of the fact I am not interested in men, I decided against a rather involved surgery to get full vaginal depth back. I use my estrogen cream to prevent further fusing. I could get a bit more depth if I would aggressively dilate daily, but, again, this would not be beneficial for me, and just cause additional discomfort.
I bet the best answers on the pain involved in vaginal surgery can be given by trans women whop had the re-constructional procedure done.
The un-fusing of the labia minora was not very painful, the maintenance of the surgical wound was less pleasant because I had to apply estrogen cream during the healing process.