Vaginal plastic surgery - indications for surgery and methods

How long should you abstain from sexual activity?

As with any type of surgery, there is usually a period of time required for recovery. You must abstain from any type of sexual intercourse for 4 weeks.

Abstinence from sexual activity

When is colporrhaphy indicated?

Indications for vaginoplasty are as follows:

• congenital anomalies of the genital organs;
• loosening and atrophic change in tissues;
• prolapse, prolapse of the uterus;
• enuresis;
• low tone and elasticity of tissues;
• traumatic injury to the vagina.

The above problems may arise due to age-related changes, complications of inflammatory diseases, difficult childbirth, previous surgeries and other factors.

Colporrhaphy can improve the functioning of the genital organs and relieve problems with urination and gas incontinence. Thanks to vaginal plastic surgery, intimate life improves and sensitivity increases.

Will it hurt?

During the procedure, the absence of pain is guaranteed by anesthesia, and you will sleep normally. This issue will also be discussed with you in detail during your initial consultation. After surgery, pain or discomfort may occur and these sensations will be treated with medication and will usually disappear within a few days.

Anesthesia

What tests and examinations should you undergo in preparation for colporrhaphy?

The list of necessary examinations is prescribed by the doctor after a preliminary consultation and examination. The list of mandatory diagnostic procedures includes:

• smear on the flora and cleanliness of the vagina;
• blood test to determine Rh factor and group;
• clinical and biochemical blood examination;
• examination for STDs, hepatitis, human immunodeficiency virus, syphilis;
• fluorography.

When preparing for surgery, a woman needs to consult an anesthesiologist and therapist. According to indications, consultations with other specialists are prescribed.

Thanks to a comprehensive examination, the doctor can identify possible contraindications to vaginoplasty, determine the technology and procedure for the operation.

Are there risks and complications?

As with any operation, there are certain risks. The most common risks include bleeding, infection. Although they are usually rare. Specific potential complications vary depending again on the volume and initial general condition of the body. All of them will be discussed with you during the consultation.

I hope that these simple questions will allow you to come prepared for a conversation with your future doctor and eliminate possible stress from the occurrence of certain situations. In any case, vaginoplasty, although not the most difficult, is still an operation and should not be taken very lightly, including by doctors.

Answered by Ivanov A.V.

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Types of Vaginoplasty

Depending on the purpose of the operation, there are:

• Anterior colporrhaphy. It consists of strengthening or suturing the muscles of the anterior vaginal wall.
• Posterior colporrhaphy. This type of vaginoplasty is aimed at surgical correction of the posterior vaginal wall.
• Median colporrhaphy (surgery to narrow the vaginal opening). The essence of this operation is to stitch together the symmetrical surfaces of the posterior and anterior walls of the vagina.

The choice of the most suitable type of plastic surgery is determined by the doctor after examining the patient.

Reviews about colporrhaphy

• Anna, 34 years old, Moscow. I gave birth twice. And every time the birth was difficult, especially the second one. Afterwards, intimacy ceased to bring pleasure to me or my husband at all. I noticed that intimacy between us was becoming less and less frequent, because we were tired, because there was no pleasure. I wanted to save my family. No, my husband was not going to leave me because of this, but I am sure that sooner or later, he would at least have someone on the side. Therefore, I decided to look for ways. At first I tried to do Kegel exercises, but did not achieve any effect. It took me a long time to decide on the operation, but I had no other choice. I was not going to give up on my intimate life at 33 years old. I spent a long time looking for a clinic, a doctor, and read reviews of women who had such an operation. It cost me 83,000 rubles, including anesthesia and fees. The sensations became brighter, I began to enjoy sex as before.
• Rimma, 38 years old, Rostov-on-Don. I didn’t really believe that such an operation could help. I did it solely for the sake of my husband, so that he could have fun, and I can say that I didn’t even think about myself. But, I was very mistaken, because now I get pleasure during sex. The operation itself seemed easy to me. Yes, it is relatively simple, but anesthesia and recovery from it are quite complex and unpleasant.
• Aida, 26 years old, Mirny. I had 2 operations performed at once: narrowing of the vagina and cervix. I would like to immediately, based on my experience, give girls advice: do the operation not in plastic surgery clinics, but in a hospital, because anything can happen, and there will be doctors there who will quickly react and take action. I did it in the hospital. Everything went well. On the 5th day I was discharged. Then for about another 2 months I avoided intimacy to be sure that everything had healed there. And one more piece of advice - do this operation after you decide that you will not give birth again.
• Margarita, 24 years old, Essentuki. For me, unlike most women, this operation was not performed to narrow, but, on the contrary, to expand the vagina. During my first pregnancy, it turned out that it was narrowed. It seemed good to my husband and I, especially during intimacy. It turned out that this is not the norm. But, during pregnancy, I could not undergo an operation of this kind, so during the birth itself they had a cesarean section, because I would not have given birth naturally. Afterwards, I decided that I needed to fix the problem so that next time I could give birth myself. Everything went fine, there was no pain, I followed all the doctor’s instructions.

How is colporrhaphy performed?

I think surgery is a last resort. There are many ways to increase your libido. For example, vaginal gymnastics. You can find a lot of different exercises on the Internet, the main thing is not to be lazy and not try to solve the problem by waving a magic wand. If you are patient, then after a month of exercise the difference will be noticeable.

When everything is torn during childbirth: the mucous membrane and muscles of the vagina, and they are stitched up somehow, the vagina turns into a pouch consisting of mucous membrane with some “interspersed” muscles that are not connected to each other. After that, at least practice, there’s still the same “nest” between your legs. The operation is simply necessary. Both for intimacy and so that in a few years the uterus does not fall out of this “nest”. My experience is two “explosive” births with an interval of 6 years, four years of fruitless Kegel exercises, my husband, thank God, is still there, I had the operation a week ago in the hospital for free (I waited 8 months in line).

How is rehabilitation after colporrhaphy going?

After vaginoplasty, the patient remains in the hospital for 2–5 days under medical supervision. For the first 2–3 days after surgery, to prevent suture dehiscence, you should adhere to a special diet (soups, semi-liquid cereals).

To speed up the recovery process and avoid the development of adverse complications, after colporrhaphy you must follow several recommendations:

• bed rest for 5–7 days;
• do not squat or sit at right angles;
• refrain from heavy physical activity and sports for 6 months;
• refuse intimate contacts for 1–1.5 months;
• wear special underwear that tightens the stomach and supports the pelvic floor muscles;
• refrain from using vaginal tampons;
• don't douche.

If after the operation there is heavy uterine bleeding and severe pain in the lower abdomen, the temperature rises or the general condition worsens, you should immediately seek medical help.

Recovery after vaginal surgery

It all depends on the individual characteristics of the body, but in most cases rehabilitation lasts 1.5-2 months. Doctors warn that you should not believe those who promise a complete absence of recovery and any restrictions. After vaginal plastic surgery, rehabilitation includes:

1. After the operation, rest and bed rest are important for five days, so many remain in the hospital.
2. It is forbidden to walk or sit for a long time for a month.
3. It is recommended to reduce physical activity, not play sports and not lift anything more than 5 kg.
4. You should refrain from eating for 24 hours, and for several months you should not eat foods that cause gas formation and constipation.

Hygiene after vaginal surgery

Proper hygiene and care of sutures is of great importance in rehabilitation. After urinating and defecating, you need to wash yourself. Within 14 days you should avoid baths, saunas and warm baths. If plastic surgery of the intimate area has been performed, then consider the following rules for caring for sutures:

1. After each urination, treatment with an antiseptic solution is important.
2. To speed up healing and eliminate inflammatory processes, you can apply napkins with Levomekol ointment to the seams.
3. For quick recovery and speedy healing within 14 days, the doctor prescribes suppositories.

Discharge after vaginal surgery

A woman may have a slight discharge of blood for some time. It is important to consider that if you had to change three filled large pads in one day, this already indicates bleeding. This is a signal to go to the doctor. The help of a specialist is needed if, after vaginal plastic surgery, the discharge contains pus. Surgical areas should be treated with an aqueous solution of Chlorhexidine.

Pain after vaginal surgery

Discomfort and moderate pain will accompany the woman for 14 days. To reduce discomfort, the doctor prescribes painkillers. It is important to consider that after specific operations, for example, if the uterus was attached to the pelvic bones, the pain may become permanent, which is explained by irritation of the periosteum. The pain is affected by the stitches after vaginal plastic surgery, and the larger they are, the greater the discomfort will be.

Sex after vaginal surgery

For proper rehabilitation and to avoid complications, doctors recommend excluding sex for two months. During the first month, successful healing may be affected by normal intimate stimulation. The thing is that increased blood circulation in the genitals provokes swelling, which can cause the stitches to come apart. If the recovery after vaginal plastic surgery went well, then no problems should arise in the future, but some women still feel slight pain during sex. It is recommended to use intimate gel.

Indications and contraindications for anterior colporrhaphy

The operation of suturing the anterior vaginal wall is carried out in the presence of the following pathological abnormalities and disorders:

• Bladder prolapse;
• Perineal rupture;
• Uterine prolapse, accompanied by prolapse of the vaginal walls;
• Stretching, drooping of the perineal walls.

Colporrhaphy is also performed as part of an episiotomy, which involves dissection of the posterior vaginal wall and perineum to avoid birth injuries in the child and vaginal ruptures during difficult childbirth.

Colporrhaphy, like any surgical intervention, has a number of contraindications. These include:

• Pathologies of the genitourinary system;
• Acute thrombophlebitis;
• Venereal diseases;
• Pregnancy, lactation period;
• Diabetes;
• Heart failure;
• Mental disorders;
• Pathologies of blood clotting;
• The presence of malignant and benign neoplasms;
• Taking anticoagulants (drugs that prevent the formation of blood clots and reduce the clotting activity of blood cells);
• Predisposition to the appearance of keloid scars;
• Damage to the skin of the genitals;
• The presence of inflammatory processes in the reproductive system.

Main types of colporrhaphy

There are two main types of colporrhaphy: anterior and posterior. In the anterior procedure, a small area of ​​the vaginal mucosa is excised in the anterior part, and in the posterior part, respectively, in the posterior part. Then the walls are stitched together. Either one of these procedures can be carried out, or both at once.

Narrowing of the vaginal opening may also be performed. In some cases, a special mesh implant may be installed to increase the elasticity of the walls. But it is usually installed on women aged 45 and above.

What do the seams look like?

It all depends on the specific situation, the area where the operation was performed. Often combined sutures are applied, since the loads in this area are quite serious. The surgeon may apply submerged catgut sutures.

To ensure that the stitched edges of the vaginal wound come into contact with wider surfaces and heal faster, when applying sutures, they often retreat from the edge of the wound by 0.7-1.0 cm. Submersible sutures are usually applied to the superficial muscles of the pelvic day and perineum. After applying submersible sutures, the edges of the wound are additionally sutured with silk ligatures.

Vaginoplasty – complications

Intimate surgeries are common and well-established, so serious complications are extremely rare. The consequences of such an intervention are more pronounced during the first week of rehabilitation. To prevent vaginal plastic surgery from leading to negative consequences, you should follow all doctor’s instructions. Possible complications:

1. During the week, slight bleeding and a slight increase in temperature are possible.
2. Painful sensations are normal, and they persist in most cases for two weeks. To get rid of discomfort, doctors prescribe painkillers.
3. After surgery, hematomas form, which resolve without additional therapy. If their area increases and pain occurs, then you should urgently consult a doctor.
4. Within a week after vaginal plastic surgery, swelling may be observed, which goes away on its own.
5. Taking into account the individual characteristics of the body, tissue may grow in the area of ​​the sutures, and therefore scars may form.

Vaginal plastic surgery - indications

There is a certain list of indications for which surgical intervention is recommended:

• pain during sexual intercourse;
• urinary incontinence;
• lack of orgasm;
• release of involuntary gases;
• prolapse of the vaginal walls and others.

Intimate vaginal plastic surgery is performed when, due to damage, a layer of connective tissue with increased density is formed. This becomes a kind of barrier to muscle contraction, which ultimately leads to an expansion of the diameter of the organ or its excessive narrowing. If left unattended, the situation will worsen, leading to more serious consequences.

Intimate contouring

This procedure is understood as a full-scale direction of aesthetic medicine, with the help of which a large number of problems are solved. Vaginal contouring involves the introduction of special medications to specific points. Thanks to this, it is possible to correct deformation, improve the condition of tissues and rejuvenate them. In most cases, vaginal contouring is used to achieve the following results:

1. Improving the elasticity and density of tissues of organs that become flabby, for example, after rapid weight loss, childbirth, due to hormonal imbalance or age-related changes.
2. Increased tissue nutrition, relief from dryness and increased hydration of the mucous membrane due to the normalization of water balance or metabolic processes.

Vaginal contouring is often used as an adjunct to other plastic surgeries. Its goal is a more subtle correction and improved tissue healing during the rehabilitation period. The procedure involves superficial anesthesia, and then injections of hyaluronic acid are given. It is performed individually, and if necessary, additional correction or a repeat procedure can be carried out, since after a while the hyaluronic acid will be absorbed and removed from the body in a natural way.

Plastic surgery of the vaginal walls

The surgery is called colporrhaphy, which affects only one part of the vagina.

1. Front wall
   . The operation is aimed at reducing the mucous membrane in order to reduce the volume of the vagina or move the bladder to its correct position. Plastic surgery of the anterior vaginal wall involves suturing. It is used to get rid of problems associated with urination and to improve sex life.
2. Back wall
   . The procedure is performed when the wall is stretched, old scars are deformed and there is a risk of uterine prolapse. Posterior colporrhaphy involves excision of excess mucosa to restore the anatomy and reduce the size of the organ.

Intimate plastic surgery for vaginal narrowing

The most popular procedure that involves suturing the vestibule is a part of the genital organs, which is a space limited in front and above by the clitoris. Vaginal plastic surgery with suturing of the perineum helps to cope with such troubles: loss of pleasure during intimacy, a feeling of internal pressure and heaviness in the lower abdomen, problems with urination, and so on. The procedure is carried out and when tissue rupture occurs. To narrow the vagina, doctors may prescribe surgery, implant threads, or inject hyaluronic acid.

Intimate plastic surgery after childbirth

Many women experience complications after childbirth that can be treated with surgery. Plastic surgery of intimate places is recommended for the following reasons:

1. Congenital characteristics that worsened after the birth of the child.
2. Changes in the structure of the genital organs, for example, weakness of the vaginal walls. Due to the stretching of the muscle ring during sex, both the woman and the man stop receiving pleasure.
3. Vaginal plastic surgery is recommended for vaginal deformation caused by rupture of the walls and severe scarring.

The reason for seeing a doctor determines what the procedure will be:

1. If a woman’s main complaint is dissatisfaction with the condition of the external genitalia. To make the correction, the surgeon excises excess tissue and restores symmetry with the opposite side.
2. If the problem is caused by muscle weakness, then conservative techniques can be used. All manipulations will be aimed at narrowing the genital gap, for which fillers are used. They can inject hyaluronic acid, as well as their own fat. In the second case, the effect of the procedure will last for a long time, unlike acid, which dissolves.
3. If the disturbances are more pronounced, then to restore the muscular frame, vaginal plastic surgery is performed, aimed at excision of the muscular membrane and further stitching of the walls. Another such solution is needed when excision of rough scars that form after problematic childbirth.

Vaginal plastic surgery after hysterectomy

Under certain conditions, removal of the uterus may be prescribed, for example, this procedure is called a hysterectomy. During this procedure, the ovaries and other organs may be removed. As a result of this procedure, the vaginal muscles become flabby and its walls become stretched, which negatively affects sensations during physical intimacy. Intimate plastic surgery in women after hysterectomy can be of two types:

1. Reducing volume and restoring tissue elasticity. To do this, the U-shaped area of ​​the vaginal walls is dissected, and then the muscles in this area are tightened, stitching the excision together.
2. Narrowing of the vaginal opening is carried out if there is no sagging. To do this, the doctor excises and then stitches a small fragment of the posterior wall. At the same time, the internal part remains untouched.