Vaginal relaxation is a weakening of the supportive muscles and ligaments of the pelvic floor. This condition, is usually caused by childbirth, aging, and problems with vaginal tissue support. This causes the vagina walls to stretch and eventually to sag and press into the wall of the vagina. Unless it is addressed, vaginal relaxation eventually develops into vaginal prolapse.
Vaginal tightening or vaginoplasty, is the surgical correction for vaginal relaxation. It aims to reduce the size of your resting (un-stretched) vagina size. The aim of surgery is to improve the tone of the vagina by tightening the vaginal muscles and support tissues and reducing the relaxed vaginal linings. It is usually a day-case, but an overnight stay may be necessary. You may have received general information from the hospital about admission and anaesthetic procedures. If you have any question, please feel free to ask, at any time, up till, when you see the pre-admission nurse or your surgeon on the day of surgery.
How is Vaginal Tigthening done?
There are three variations of vaginal tightening surgery designed to address the various concerns of vaginal relaxation in women. Any associated vaginal wall prolapse can usually be relaired if the surgery is conducted by an experience gynaecological surgeon, rather than a plastic surgeon with an interest.
- Vaginal Tigthening at the Entrance (Perineoplasty)
- Vaginal Tigthening Through Back Vaginal Wall (Posterior Vaginal Tightening)
- Vaginal Tigthening Using Front and Back Vaginal Wall (Combined Anterior and Posterior)
- Lateral (Para-) Vaginal Tightening
Vaginal tightening is usually performed under general anaesthesia, although it can also be done under local anaesthesia, if it is mainly for the entrance or lower portion of back wall of the vagina. The perineioplasty and posterior vaginal tightening procedure involves a diamond-shaped cut at the entrance of your vagina. This allows access to and dissection of the stretched tissues at the back of the vagina, which is joined together and shortened with dissolvable stitches, and the unwanted overlying vagina skin is removed. This tightens vaginal and surrounding soft tissues and reduces excess vaginal lining. The stitches are mainly inside the vagina, but the perineal incision will show additional stitiches, depending on how much this area needs to be repaired and tightened . The combined anterior and posterior wall tighteing is usually done for larger stretchy vagina. It is not uncommon to find that the vagina can be stretched easily to four-fingerbreath (width), without it causing much discomfort in someone with vagina relaxation. In these cases, excess skin will need to be carefully removed from the front wall and rarely the side vaginal wall (lateral or para-vaginal tightening), to achieve the necessary tightening. Para-Vaginal or Lateral Vaginal Tightening may sometimes be done in women who are very concerned about and able to identify their specific “G – Spot”. It is important that know that what is referred to as “G-Spot” is not a “structure” that can be seen during examination or operation.
Local anaesthetics are sometimes injected to reduce pain immediately after operation. The operation will take just over 1 hour unless it is carried out with other procedures, when it may be longer. No dressing is necessary, but a gauze pack may be used to reduce bleeding and apply local antiseptic solution. If this pack is used, it is customary to put in a small tubing (catheter) to empty your bladder, as it will be difficult for you to pass urine with the pack inside. If a catheter is used, it will be removed as soon as the pack is removed. You will be sent home when you are ready with antibiotics for about five days.
What about recovery?
After surgery, there will be some discomfort around the stitches. There may also be some swelling. This may take up to 2 weeks to disappear. You need to avoid bruising to the area. This can happen for example with vigorous or gym exercises, horse- or bicycle riding or prolonged sitting or during vaginal intercourse. There may be a little bleeding, which quickly changes to pink and then disappears. You will need to wear a panty liner during this period. Between four to six weeks, you should be able to resume gentle exercises and sex. You can take a daily gent le short bath or normal shower to ensure quick healing. Follow up visits will be scheduled to check on your progress. It is usual to be able to return to work in about 5 – 7 days, but this depends on the individual. In some people this can take up to 4 weeks. Resting is important to healing process. The vagina skin does not heal with the same type of scarring as the normal outside skin. With the use of dissolvable stitches, and the prevention of infection, – and if necessary – subsequent use of lubricating gel or vaginal oestrogen, hormonal preparation, this problem can be reduced to a minimum. With regular stretching of the vaginal skin, through use or other methods (such as vaginal dilators), the vagina is usually fully restored to normal, with time. It is important to note that this may take up to three months after surgery. It is also common to have some discomfort or pain at the initial period of resuming sex. This gradually gets better with use.
Are there any risks?
No one wishes for any complications, but in the best of hands, these can happen. Your surgeon will explain this further before you gave consent for the operation and he will be able to reassure you. These include:
- Bleeding; in or around the area of surgery. The surgeon ensures this does not happen
- Infection, – antibiotics are given during and usually after the surgery.
- Over-tightening of vagina may occur. This is very rare in younger ladies and may require stretching with the use of vaginal dilators.
- Discomfort during sex. This usually stops after a few episodes of sexual intercourse
- Changes in skin sensitivity, such as numbness may occur at the perineum. Delayed wound healing