What is a vulvo-vaginoplasty?

A vulvoplasty is a surgical modification of the external genitalia in a woman. It can entail modification of the labia majora, labia minora, clitoral hood or perineum. A vaginoplasty (also known as lateral colporrhaphy) is a procedure designed to tighten the vagina. An alternative is noninvasive vaginal tightening through heating tissues with radiofrequency waves or laser. Patients with significant laxity may not experience a benefit from these treatments and may be better candidates for surgical tightening with vaginoplasty.

Reasons patients want a vaginoplasty

After childbirth, women may complain of vaginal laxity, resulting from stretching of tissues and separating of muscles, sometimes to the point that a tampon falls out, and this lack of tone can contribute to sexual dysfunction.

Reasons patients want a vuvloplasty or labiaplasty

The patient’s labia minora may be excessive which can cause functional problems like a recurrent fungal infection, painful intercourse or dyspareunia due to skin redundancy, or pain when exercising such as riding a bike, in addition, it may lead to a cosmetic deformity in which the patient does not feel comfortable with the appearance. These tissues may be modified to minimize these functional problems.

What does a vaginoplasty do?

A vaginoplasty or lateral colporrhaphy will bring the separated muscles and mucosa closer together, leading to a more constricted vagina which will commonly enhance the sensation during penetrative vaginal intercourse. The external skin at the 6 o’clock position may be removed so that this skin redundancy does not also cause pain on intercourse.

Anesthesia for a vaginoplasty

While a vaginoplasty can be done under local or regional anesthesia, or the patient may opt to have it done under general anesthesia.

Vaginoplasty procedure

Once the amount of tightening to be done is determined, a local anesthetic is injected and excess mucosa is removed from inside the vagina laterally. Beneath the skin, the muscles are tightened with strong sutures. Once the vaginal canal has been tightened, the mucosal skin is sutured closed. If there is external skin that protrudes, this can be reduced as well for a more aesthetic result.

What are the risks of a vaginoplasty?

Risks from vaginoplasty include infection, bleeding, pain, along with rare complications such as overtightening.

Recovering from a vaginoplasty

Patients may have one to two weeks of downtime. They may feel a deep ache for the first few days, and there is no tampon use or intercourse for six to eight weeks.

What are the results of a vaginoplasty?

This procedure typically results in a tighter vaginal canal, which can help enhance sexual satisfaction. In addition, the vulvoplasty whether it be a labia minora or majora reduction or augmentation of the labia majora with fat or a dermal fat graft may significantly enhance the sexual experience, decrease any functional problem and enhance cosmesis.

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