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Vaginal plasty / vaginoplasty

It is generally a vaginal correction for women. The most common intervention is the narrowing of the vaginal entrance or the entire vagina, which can partially tighten it. The treatment should enable or improve the sexual life of the patient.

This operation is usually carried out on middle-aged women who have already given birth and who lose their elasticity as a result of childbirth and with increasing age.

The treatment is carried out under general anesthesia and lasts 45-60 minutes. In the area of ​​the vaginal entrance, on its back wall, the tissue is excised to various extents (according to the patient's wishes, anatomical findings, etc.). The wound is then sutured. It is cheaper to perform the excision to a larger extent and thereby narrow the vaginal entrance more, as it can usually stretch again slightly over the years.

The procedure not only affects the mucous membrane, but also affects the muscle layer of the vaginal wall. The vaginal mucosa is first cut out to the required (desired) extent, then the muscle layer of the vagina is attached and shortened and finally the vaginal mucosa is sutured. The same applies to the extent of the excision as to the correction of the vaginal entrance. During this operation, the surgeon must proceed very carefully and have experience, as the vagina is very close to the large intestine and the formation of a so-called "rectovaginal fistula" must be avoided.

Absorbable sutures are used during the operation.

Postoperative care is simple and the patient takes care of it herself. She has to ensure perfect hygiene, showering with soap or shower gel is recommended, at least twice a day using a disinfectant solution, which you get when you correct the labia. Initially, sterile gauze should be placed in the underwear, later panty liners are sufficient.

If the course is normal and the sutures are absorbable, it is not absolutely necessary to have a check-up after the operation, but it is advisable to go for a check-up after a week or two. A check-up after about 3 months is also recommended in order to assess the final result. Of the later complications, the formation of tight scars should be mentioned in patients who have a congenital tendency to develop keloids and hypertrophic scars. This risk is less than 1% and can be eliminated with special care for such scars.

With vaginoplasty, the vagina is tightened - mainly for cosmetic reasons. Muscles and various tissues in the vaginal area are sewn together to make the vaginal cavity smaller.

How does it work?

What is a vaginoplasty?

Vaginoplasty is a form of invasive surgery that makes the vagina appear youthful again.

Why a vaginoplasty?

• In some cases, the procedure is used to reconstruct a vagina or, in the case of a sex change, shape it from penile tissue.
• For some patients, shame about the appearance of the vagina disrupts their sex life.
• For others, the loss of friction during intercourse is a problem.
• However, many patients seek vaginoplasty for chronic complaints.

How does a vaginoplasty work?

The engagement

• The surgeon begins with an incision or series of incisions in the vaginal walls.
• The muscles on both sides of the pelvis are tightened with self-dissolving sutures.
• Excess vaginal lining and tissue are removed during the procedure.
• If there are no complications, the patient can return home the same day.
• The results
• Sewing muscles and tissues together essentially reduces the size of the vaginal cavity.
• This increases friction, and some say the intensity of feeling, during intercourse.
• Significant cosmetic improvement is also achieved, often compared to having a youthful vagina before pregnancy.
• In addition to the obvious cosmetic benefits, vaginoplasty can provide better support for the uterus, bladder, and intestines. This can alleviate related complaints such as incontinence.

Are there different types of vaginoplasty?

A simple cosmetic vaginoplasty takes just an hour. However, more complex versions of the operation are required for more serious problems.

Intestinal vaginoplasty

This procedure involves using a section of the S-bowel to create a new vaginal wall. This type of vaginoplasty can be performed laparoscopically (laparoscopy).

Peritoneal vaginoplasty

This procedure is also known as the "Luohu operation" and uses the peritoneum to create a new vaginal wall.

This laparoscopic procedure carries the risk of a fistula, but does not require a vaginal dilatation set after surgery.

McIndoe

The McIndoe technique uses a skin graft instead of the peritoneum. The graft is first placed on a mold and then inserted into the vagina.

However, because the skin does not release moisture, women who undergo this procedure must use a vaginal dilatation kit regularly for the rest of their lives.

Buccal mucosa

The lining of the cheek is a natural tissue that is formed in the lining of the mouth. It is quite similar to the lining of the vagina, which makes it suitable for a very specific type of vaginoplasty.

However, this method is used relatively infrequently because the tissue available for use is limited.

Inverted penile skin

Vaginoplasty with inverted penile skin is used for sex reassignment operations.

The skin from the outside of the penis is removed and then turned inside to form the wall of the new vagina. The glans penis is used to form a clitoris and the skin of the scrotum to form the labia.

Labia correction

Labia surgery (labioplasty) is not a vaginoplasty, but it is worth mentioning in this context.

Some surgeons perform both procedures at the same time. The labia correction reduces and remodels the skin flaps on both sides of the vagina (labia minora / small labia).

What is ahead of me

The procedure is performed on an outpatient basis under local anesthesia. However, your surgeon may recommend general anesthesia. Then a nightly stay in a hospital or clinic may be necessary.

Results

The success rate of vaginoplasty is very high. However, reconstructive interventions are not quite as successful in this context. Even so, there is a chance that you will get the results you want.

Pain and recovery period

• After the procedure, you will experience pain and discomfort at the incision site for a few days. You may be prescribed a pain reliever to aid your recovery. Ice packs can also help reduce pain and swelling.
• Avoid doing heavy household or work tasks for at least 4 weeks. However, there is a good chance that you can get back to a relatively normal everyday life in a fraction of that time. However, you may have to attend outpatient follow-up appointments for up to a year after the procedure.
• After 2 or 3 days you should be able to walk normally, albeit slowly.
• Most patients can return to normal sex life relatively quickly after the procedure. However, you should definitely proceed at your own pace.
• Risks and Side Effects
• Risks and serious side effects are rare. However, it is always best to know them before undergoing vaginoplasty.
• For example, if you have a vaginal prolapse or chronic bleeding, you may need further treatment.
• You may also have to prepare for being on sick leave longer than expected or not being able to take up household chores.