Abstract: An expandable vaginal dilator includes a stretchable sheath defining at least one fluid chamber therein and being shaped and sized according to vaginal measurements and physical examination. A support within the sheath seals and holds the sheath and provides one or more fluid channels configured for delivery of fluid into the at least one fluid chamber to expand the sheath. The support is configured to permit vaginal insertion of the sheath when the sheath is in an unexpanded state and to stabilize the sheath during expansion of the sheath. One or both of the sheath and support can be sized and shaped according to the physical exam of a patient. One or both of the sheath and support can be configured to provide differential expansion according to the physical patient information and a treatment plan.