The Vaginoplasty/Vaginal Rejuvenation/Vaginal Tightening or Posterior Vaginal Repair is a surgical procedure performed to fix Vaginal Relaxation. Women with vaginal relaxation often complain they no longer feel the same amount of friction during intercourse. They will often describe vaginal looseness as a decrease in a woman’s ability to attain vaginal orgasms.
The main component of the lack of friction is the relaxation of the posterior inner vaginal wall. This is usually a component of relaxation at the vaginal opening. The cause of vaginal wall relaxation is a weakening of the pelvic support structures and thinning of the recto-vaginal septum in the posterior vaginal wall as figure 1.
The underlying causes of thinning of the Recto-Vaginal Septum are:
- Multiple or prolonged deliveries.
- The use of forceps, vacuum, or other assisted methods of delivery.
- A history of constipation and straining with bowel movements.
- Perineum tears or an episiotomy into the rectum or anal sphincter muscles.
- Aging, occasionally likely in younger women or in those that have not delivered children.
- This problem may be preceded by hysterectomy, because it is involved in damaging different structures supporting pelvic organs, ligaments and tissues around cervix supporting the anterior and posterior vaginal wall.
Symptoms of Posterior Vaginal Wall Prolapse:
- Rectal pressure
- Pain in the lower back
- Flatulence incontinence
- Rectal pain and vaginal bulge
- Failure to completely empty the bowel
There are 4 methods of correcting relaxation of the vagina:
- 1) The Kegel Exercise is safe but would have to take 6 months until results would show, and does not guarantee full effectiveness.
- 2) The Incisionless Laser Vaginal Tightening is a new trend of innovation to the Cosmetic Gynecology for mild to moderate vaginal relaxation; this procedure has limitations and cannot guarantee the results and satisfaction.
- 3) The Vaginoplasty or Posterior Vaginal Repair is the surgery to narrow the diameter of the vagina which results to a smaller, and tighter vaginal canal and vaginal opening. However, this surgery also has its limitations to the women with multiple deliveries.
- 4) The Anterior and Posterior Vaginal Repair (A-P Vaginal Repair) is the surgical repair of pelvic prolapse by entailing the surgical removal of the excessive anterior and posterior vaginal tissues as well as bladder and rectum prolapse, thereby correcting the pelvic organ prolapse, at the same time tightening the vagina.
Recently, Laser has been applicable to the Vaginoplasty/Posterior Vaginal Repair. Benefits of Laser Vaginal Rejuvenation include: More precision and accuracy as a result of the surgical wound control, less blood loss, less risk of vessel and tissue damage, and quicker recovery time, thus bringing about better results than using the old conventional scalpel surgery.
Figure 1: Thinning Posterior Vaginal Wall between Rectum and Vagina
General Notes & Precautions
1) Important points to consider about the Vaginoplasty/Posterior Vaginal Repair
- This surgery aims to tone and tighten lax and overly stretched vaginal muscles and tissues. This is done by removing excess posterior vaginal mucosa to correct defects in the posterior vaginal wall and to narrow the diameter of the vagina which results in a smaller and tighter vaginal canal, thus permitting greater sensation during sexual experience. The tightening is done in the entire length of the vagina and not merely in the opening, differing from the perineoplasty surgery.
- Like any other surgeries, this surgery has limitations and cannot absolutely ensure satisfactory results, because there are so many factors affecting the surgery’s success. In case of unsatisfactory results or complications, correction surgery may possibly be performed as appropriate. This will be discussed by you and Dr. Vitasna.
- If correction surgery happens due to a complication of the surgery, all expenses for services and treatment will no longer be charged to you. However, if the unsatisfactory results occur due to your non-compliance with the doctor’s orders, you will be charged accordingly.
- This surgery is not allowed for women with immunodeficiency. In addition, you must not become pregnant, or plan to become pregnant in the next 3 months. This is a suggestion, despite no research about the disadvantage to the pregnancy and the newborn.
- This surgery is not recommended unless you have a discussion with your spouse because this may lead to problems, and misunderstandings caused by refraining from sexual intercourse for quite a time.
- This surgery is performed in our operating room for approximately 1-2 hours under the Intravenous (IV) Sedation and Local Anesthesia, or the General Anesthesia. You have to refrain from drinking water or food for at least 6 hours prior to the surgery in order to decrease the risk of aspirating gastric contents during or after the surgery. This complication is very serious, and you need to strictly follow our recommendations. Within the day of the appointment, you should not drive yourself after the surgery to avoid any accidents caused by dizziness, an effect of the Intravenous Sedative or the General Anesthesia used during the surgery.
- You should take a rest (refrain from any physical activities) and be still for at least 2-3 days after the surgery to enable the wound to heal faster. You may return to work within 3 to 5 days after surgery, you should have little movement as possible to avoid wound disruption for 1-2 weeks after the surgery. You should refrain from some types of exercise affecting pelvic muscle movement and sexual intercourse for at least 6-8 weeks after the surgery.
2) Before the Vaginoplasty/Posterior Vaginal Repair
- Prior to the surgery, you will be invited to a pre-operative consultation room, where you will be evaluated for the surgery. You will be received by a member of the nursing staff in our Center, who will make inquiries regarding your previous medical history as well as arrange for your vital signs such as temperature, respiration, blood pressure, and pulse. In case of existing diseases or drug allergies, please inform the medical staff before the consultation. You should prepare and take with you any pills or treatment medications, you are currently taking.
- You can possibly have the surgery done on the day of your consultation depending on the availability of Dr. Vitasna’s schedule. Otherwise, you may book for a possible surgery on the day of your consultation. This you may do through online pre-consultation and arrangement. It is best to undergo the surgery after your period. It is not advisable to do the surgery just before the period starts or during the period.
- A staff nurse will usher you to a treatment room, where Dr. Vitasna will investigate your health history, and conduct both a general check-up and internal check-up. In case you have vaginal fungal or bacterial infection, you should completely treat it before the surgery to avoid wound infection after the surgery.
- After the examination and assessment, you will discuss with Dr. Vitasna about your expectations and concerns. She will then explain to you about the methods (or techniques), processes of the surgery, some potential post-operative risks and complications prior to decision-making. You may also be asked if you have any allergies or any condition that wouldn’t make you a good candidate for the surgery as well as other additional inquiries.
- After you have chosen the best alternative for your case, prices and quotes will be written down with you. —This ends your consultation.
3) The cost of the Vaginoplasty/Posterior Vaginal Repair
- The cost of the surgery will include professional fees for the anesthesiologist and the surgeon, all the instruments, home medications, and medicines used for the surgery as well. Fees for laboratory work-up for other existing diseases that you may have, and the professional fees for the anesthesiologist and the surgeon for corrective surgery are not included in the package.
The Processes of the Vaginoplasty/Posterior Vaginal Repair
1) On appointment day you plan to have the Vaginoplasty/Posterior Vaginal Repair
- You have to refrain from drinking water or food for at least 6 hours prior to the surgery. In addition, it is advisable to have a bath or perhaps a shower before you come into the hospital. You may need to bring along with you loosely fitting daytime clothing, personal hygiene stuff, loose fitting underwear, and sanitary pads.
- Before you go through the pre- operative processes, if you have more questions you will meet Dr. Vitasna for any additional information. In case of uncertainty, doubt and worry, or for being uncomfortable for any reason, you should postpone the surgery.
- If you are a good candidate for the surgery, our medical staff will assess your vital signs, help you sign, and review the proper consent forms, which give us permission to perform surgery on you. Then a staff nurse will review the post-operative care instructions, which you need to do after the surgery, and will guide you through the process of payment.–After that a member of staff will accompany you to the Inpatient Building.
- As you arrive in the Inpatient Building, a staff nurse is going to check your information (name, birth date), show you your bed, assist you to change into a gown, and provide you with an identity wristband. She will assess your vital signs as well as arrange for some medical tests, i.e. blood tests (CBC and Anti- HIV), ECG, and probably a chest X- Ray.
- You will be directed to the anesthesiologist, who will administer the anesthesia during the surgery. Please tell him/her about your allergies to medications, your medical history, dental treatments, previous surgery (s) you have had, and any family history with anesthesia problems.
- If you are wearing nail polish or makeup, you may be asked to remove it. Contact lenses are to be removed as well as glasses and dentures. Jewelries are also to be taken out. Should you be unable to remove some piece of jewelry, a protective tape will be placed over it.
- After all these have been done, a staff member will accompany you to the operating theater, and will hand you over the care of the anesthetic team. A staff nurse is going to check your information (name, birth date) and your vital signs. — Once everything is complete and in order, a nurse will take you to one of the operating rooms.
Vaginoplasty/Posterior Vaginal Repair is one of the most complex and meticulous cosmetic surgeries performed today. It requires extensive experience, precision, and accuracy to create the optimal results you desire and deserve. Many surgeons have little to no experience with this type of advanced cosmetic surgery. You should research and be conscious of the surgeon’s educational background, training, and practical experience.