The Processes of the Vaginoplasty/Posterior Vaginal Repair
1) During the Vaginoplasty/Posterior Vaginal Repair Surgery
While you are sleeping, Dr. Vitasna will remove the excess posterior vaginal wall tissues bulging into the vagina. Thus, the posterior vaginal wall tissues are separated forming an inverted V shape incision with its narrow side near the cervix and the wide one near the vaginal opening as figure 2.
Figure 2: The inverted V shape incision
Afterwards, Dr. Vitasna will suture edges of the wound or two sides of the V- shape incision with slow absorbable suture beginning with the narrow (cervical) side (Figure 3). She will do the suturing and tightening along the entire length of the posterior vaginal wall (Figure 4). The suturing is done alternatively with 2 or 3 layers to avoid the post-operative bleeding.
Therefore, the Vaginal Relaxation will be corrected, and the vaginal wall will become more strengthened. Vaginal packing is done for 24 hours after the operation to control and stop the bleeding, and a urinary catheter will be inserted for 1-2 days after the surgery.
Figure 3: Dr. Vitasna will suture edges of the wound or two sides of the V- shape incision.
Figure 4: The Suturing for Vaginoplasty/Posterior Vaginal Repair along the entire length of the posterior vaginal wall
2) After the Vaginoplasty/Posterior Vaginal Repair
After the surgery, you are assured to be well taken care of in a safe and professional way by our highly trained and educated staff. You will be monitored at the recovery room for 1-2 hours. When you are conscious with normal vital signs, the anesthesiologist will allow you to be monitored in the Inpatient Building. Nausea and vomiting may be experienced, as a side effect of the Intravenous sedation or the General Anesthesia, which is noted to be relieved as soon as its effect wears off.
In the Inpatient Building, you will be given an antibiotic to prevent post-operative infection, a laxative drug to prevent constipation, an anti-inflammatory drug, and an acetaminophen to lessen the wound pain.
Pain levels depend on an individual’s pain tolerance. Pain varies from person to person. If the pain cannot be relieved from the acetaminophen, the nurse will administer an analgesic by injection as ordered by Dr. Vitasna.
In our hospital, clients can choose to pay for a “pain-free program”, where you will be given a machine that you can control and enables you to give yourself appropriate levels of pain relief.
Within the first 1-2 days after the surgery, you should not take a shower, which may potentially cause infection –perhaps rub the body dry. Cleaning the perineum area after fecal excretion done using water and toweling gently.
After 1-2 days of the surgery, you will be able to have movement and walk around. The urinary catheter will be removed.
Dr. Vitasna will allow you to return home after the following things are checked:
- 1) No abnormal bleeding from the surgical wound.
- 2) You can urinate after the urinary catheter removal.
- 3) You are asked to review the post-operative care instructions.
Read more about the Vaginoplasty/Posterior Vaginal Repair
3) Post Operative Care Instructions at home after the Vaginoplasty/Posterior Vaginal Repair
At home, you must take an antibiotic, an anti-inflammatory drug, a laxative, and an acetaminophen. The antibiotic should be completely consumed according to schedule.
After 1-2 days of the surgery, you are allowed to take a shower. You should clean the surgical wound at the perineum area with soap daily, when you are taking a shower in the morning or before bedtime. Do not put anything to clean inside of the vagina.
Within the first 2-3 days after the surgery, you may experience an urge to pass stool (straining), and a sense of incomplete emptying, even after the enema before the surgery. This is caused by the sutured posterior vaginal wall between rectum and vagina, you should take a rest to reduce this symptom (refrain from work) and be still to enable the wound to heal faster.
You may experience light reddish bleeding out of the vagina in around 1-2 weeks after the surgery. A slim sanitary napkin should be used to monitor the post-operative bleeding. In case of a lot of bleeding or reddish blood clot, swollen reddish wound and high fever, please contact the Hospital for suggestions or come to see Dr. Vitasna for the surgical wound examination.
Within the first 2 weeks after the surgery, cleaning the surgical wound at the perineum area after urinary excretion may be done with sanitary wipes, and after fecal excretion done using water and toweling gently. You should try to avoid moisture around the surgical wound to keep the area dry to let it heal faster.
After the surgery, you may have all kinds of food, with the exceptions of alcoholic drinks, pickled food, and smoking for about 2 weeks.
The material used for the surgery is the suture which dissolves slowly (within 6 weeks). However, for some women, the suture takes longer than 6 weeks to completely dissolve. Itching and irritation may be caused by the dissolving sutures and the process of healing. Dr. Vitasna may prescribe antihistamine to relieve the itching.
You may have abnormal vaginal discharge, a green-yellowish discharge after the surgery, because the vagina is full of secretion fluid and various kinds of bacteria. This can cause reaction to the surgical wound and sutures. Complete absorption of the sutures will usually occur within 6-8 weeks. Green-yellowish discharge may also persist during this time.
You may experience itching or curd like discharge as a result of vaginal fungal, possibly following taking antibiotics to avoid post-operative infection. In case of smelly vaginal discharge or vaginal fungal infection, you have to take additional medications.
4) Recovery period after the Vaginoplasty/Posterior Vaginal Repair
Recovery varies individually. You may return to work within 3-5 days after the surgery. Dr. Vitasna will have a post-operative appointment with you within 1-2 weeks after the surgery, you should follow Dr. Vitasna’s appointment for follow up examination or treatment.
Within the first 2 weeks after the surgery, tissues are beginning to produce and form new blood capillaries, and the surgical wound are expected to start healing. You may start your daily activities gradually.
After the first 2 weeks to 4 weeks after the surgery, the surgical wound is expected to heal appropriately, you may start your usual activities gradually. Strenuous physical activities should be limited.
After 4 weeks of the surgery, you may do your usual activities, relaxing exercises and lifting light weights are permitted. However, you should refrain from running, soaking in the bathtub, swimming, heavy lifting, cycling, other heavy activities, and sexual intercourse for at least 6-8 weeks after the surgery.
If you decide to have a consultation with Dr. Vitasna, please call or e-mail a member of staff to make an appointment date for the surgery.
The rate of surgical complications after the Vaginoplasty/Posterior Vaginal Repair is low, especially when laser is utilized by an experienced surgeon, and you carefully and religiously follow our post-operative care instructions. In the unlikely event of a post-operative complication, you should immediately see Dr. Vitasna for early examination and treatment and prevent worsening of the complication.