Reconstructive Surgery – Female
Vaginal muscles, due to stressful expansion during the childbirth process, experience enlargement. This can often result to loose and weak vaginal muscles.
Kegel exercises alone can’t improve the condition of the vaginal muscles. Because of this, many women resort to surgical procedures to remedy their problems.
Vaginoplasty, also known as v-tuck, is a standard gynecologic surgical operation. The procedure tightens vaginal muscles and surrounding soft tissues by reducing excess vaginal mucosa or vaginal lining. This results in an immediate decrease in the size of the vaginal muscles.
Labiaplasty is for women who have a problem with large labia, asymmetric labia, or related female genital issues.
Vaginoplasty aims to improve the tone of the vagina by tightening the vaginal muscles and its supporting tissues. The stretched muscle at the back of the vagina is joined together and shortened with using dissolvable stitches. The unwanted skin is then removed after that. Due to the reduced excess vaginal lining, the vaginal muscles and it surrounding soft tissues are tightened. The scarring occurs inside the vagina.
Vaginoplasty is expected to also restore the vagina and supporting structures to a pre-pregnancy state.
Aside from women who want to tighten their vaginal muscles and it supporting tissues, other suitable candidates for vaginoplasty are women suffering from stress incontinence, or the involuntary loss of urine with coughing, sneezing, laughing, exercising or sex, women wanting to improve the appearance of their external genitalia, restore their self-esteem and revive their love lives are also good candidates for the operation..
Vaginoplasty is not, however, recommended for women who had just given birth. Doctors usually advised women who are interested to have V Tuck performed on them to wait for about a year after childbirth.
A V Tuck can be done alone or in combination with other cosmetic gynecologic procedures like labiaplasty.
Every woman is different. The lips of the vagina are not always equal. It is not uncommon for one to feel dissatisfaction from this, especially if the disproportion is particularly noticeable. This can be uncomfortable, embarrassing even, for a woman. It may lead to sexual dissatisfaction or difficulty. Labiaplasty is the answer for this dilemma.
Labiaplasty is expected to restore the appearance of a woman’s genitalia to normal.
A vaginal prolapse is a condition in which structures such as the uterus, rectum, bladder, urethra, small bowel, or the vagina itself may begin to prolapse, or fall out of their normal positions.
Without medical treatment or surgery, these structures may eventually prolapse farther and farther into the vagina or even through the vaginal opening if their supports weaken enough
The following are types of vaginal prolapse:
- Rectocele: This type of vaginal prolapse involves a prolapse of the back wall of the vagina. The rectal wall pushes against the vaginal wall, creating a bulge. This bulge may become especially noticeable during bowel movements.
- Cystocele: This can occur when the front wall of the vagina (pubocervical fascia) prolapses. As a result, the bladder may prolapse into the vagina. Urinary incontinence is a common symptom of this condition.
- Enterocele: The weakening of the upper vaginal supports can cause this type of vaginal prolapse. This condition primarily occurs following a hysterectomy.
- Uterus prolapse: This involves a weakening of a group of ligaments called the uterosacral ligaments at the top of the vagina. This causes the uterus to fall, which commonly causes both the front and back walls of the vagina to weaken as well.
- Vaginal vault prolapse: This condition is common after a hysterectomy, with upwards of 10% of women developing a vaginal vault prolapse after undergoing a hysterectomy..
Approximately 30%-40% of women develop some presentation of vaginal prolapse in their lifetime, usually following menopause, childbirth, or a hysterectomy. Most women who develop this condition are older than 40 years of age.
Causes and risk factors of a vaginal prolapse include the following:
- Childbirth (especially multiple births)
- Menopause Hysterectomy
- Advance age
- Dysfunction of the nerves and tissues
- Abnormalities of the connective tissue
- Strenuous physical activity
- Prior pelvic surgery
Vaginal Prolapse Diagnosis
Generally, the most reliable way that a doctor can make a definite diagnosis of any type of vaginal prolapse involves a medical history and physical examination of the woman. This involves the doctor examining each section of the vagina separately to determine the type and extent of the prolapse and what type of treatment is most appropriate.
- Bladder function test is URODYNAMICS. This is important clinical investigation that may assist the surgeon in selecting the correct type of surgery. For further diagnostic purposes, if indicated: Ultrasound and Cystourethroscopy should be done.
Vaginal Prolapse Treatment
Most vaginal prolapses gradually worsen and can only be fully corrected with surgery. However, the type of treatment that is appropriate to treat a vaginal prolapse depends on factors such as the cause and severity of the prolapse, whether the woman is sexually active, and the woman’s treatment preference.
- Nonsurgical options may be most appropriate for women who are not sexually active, cannot undergo surgery because of medical reasons, or experience few or no symptoms associated with the condition.
- Surgrical repair is the treatment option that most sexually active women who develop a vaginal prolapse choose because the procedure is usually effective
Meshes: Many doctors now use mesh as a vaginal prolapse treatment. These mesh repairs may be as effective as traditional surgical procedures, while smaller incisions potentially minimize pain and recovery time.
What to expect during the procedure
Typically, these minimally invasive prolapse treatment procedures take place on an in-patient basis and are performed under anesthesia. Minimally invasive mesh repair procedures generally follow these steps:
- A vaginal incision and a few small skin incisions are made. You may either have an incision at the crease where your upper thigh meets your buttocks or in the middle of your buttocks on both sides.
- The mesh is inserted through an incision, placed in the body, secured with stitches, and the incisions are closed.
The use of mesh in surgical procedures is not new, and is commonly used. Mesh used for vaginal prolapse surgery is light, soft, porous, and pliable, allowing your own body’s tissues to grow in and around it. Once placed, you should not feel the mesh inside you.