Vagina is the muscular canal connecting cervix to the perineum through the middle opening in the pelvic region. Earlier, this was not a comfortable area for females to talk about. But due to better awareness, the importance of well maintained vagina is being recognized by all.
As one ages, pelvic and vaginal tissue become lax, so does vaginal canal walls. Females start finding difficult to place tampons in place, which slips out easily.
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They experience decreased sexual pleasure with their partners. Constant feeling of something coming out of vagina and lower pelvic heaviness is there, even when there is no utero-cervical descent. Coughing or constipation makes things worse.
Hence, the need for vaginoplasty or posterior colporrhaphy. Recently there has been surge in the demand of ‘designer vagina’ surgeries. Females from age group late 20s to 60s want to get tighter vagina. Reasons are obvious. Good intimate health and quality of life should be maintained no matter whatever your age is.
Females today have option of both surgical and non surgical vaginal tightening and they are often confused as to which one to choose. Let us see when should surgical approach be chosen:
1. When there is a large area of vaginal laxity, surgical approach is usually preferred.
2. When the patient is outstation or coming from far away place, it is better to go for surgical method as coming again and again is often difficult.
3. When other surgical procedures need to be combined along with vaginoplasty eg cystocele repair or hymenoplasty, it is best to go for surgical approach.
4. When your family is complete and you want to retain results for longer time.
Surgery is usually preferred to be done immediate post menstrual. Females who only use tampons during menses, should get their menses postponed as tampon should not be used for atleast 8 weeks.
Detailed history is taken to assess the number of childbirths, if any and any other co existing morbidity. Any condition leading to increased abdominal pressure like chronic cough or constipation should be revealed and treated prior to surgery.
Examination is done to assess degree of posterior vaginal wall laxity. Also note is made up of any internal infection which is treated prior to surgery. Any additional skin tag or any other local pathology is noted.
Females are also assessed for any co existing conditions eg if need to do anterior vaginal wall repair, labioplasty, etc, patient is well informed during pre operative assessment.
Any co existing urinary leakage problem is also assessed.
Blood tests and necessary investigations are advised to assess general condition of the patient.
If there is a small length of vaginoplasty, usually it can be done under local anaesthesia and is done as a daycare procedure.
If it is a very large vaginoplasty, general anaesthesia is preferred. One day admission can be offered to the patient to allow intravenous analgesics and antibiotics to be given which helps in better recovery.
Patient is allowed to come only with one attendant to avoid overcrowding.
Patient can have light meals and come, if the surgery is decided for local anaesthesia. However, if the patient has opted for general anaesthesia, patient should be empty stomach , i.e. no food, liquids including water orally for atleast 8 hours prior to surgery.
There should not be any upper respiratory tract infection or any fever at the day of surgery or any other major contraindication.
Patient is asked to fill the consent form which also briefs about the possible complications.
It is preferable if pubic hair trimming is done 2 days prior to the surgery to avoid any fresh cuts.
Preoperative photograph is taken.
Local anaesthesia sensitivity testing is done.
Patient is asked to pass urine and proceed to OT room.
Patient is put in lithotomy position and depending on anaesthesia decided previously, case is proceeded. End point of vaginal laxity is marked. Vaginal mucosa and fascia is separated till there. Underlying muscles are tightened. Any extra vaginal tissue is trimmed and closure of vaginal mucosa done. Introitus opening is also sutured in such a way as to give aesthetically pleasing look.
Sutures used are usually dissolvable.
Additional surgery, if any, is also done along.
Vaginal packing may or may not be kept depending on hemostasis and degree of vaginoplasty.
Urinary catheter is usually kept if anterior vaginal wall repair is also done along.
Patients are usually asked to take adequate rest.
A course of antibiotics and anti- inflammatory drugs are prescribed. Local ointments have to be applied.
Constipation is to be prevented, so laxatives can be taken.
Local hygiene is to be strictly maintained so as to prevent infection.
Any heavy work or exercise or squatting to be avoided for 4 weeks.
Sexual intercourse or tampon insertion is to be prevented for 8 weeks atleast.
Mild bleeding, pain and infection are short term complications.
In long term complications, patient can have scarring and dyspaurenia.
Lubrication is usually recommended initially on restart of sexual activity to avoid dyspareunia.
Patients are usually called 1 week post operatively and then after a month to assess the healing of vaginal mucosa. Usually, office can be resumed from after a week of surgery if job profile is not too hectic. Any condition which increases intra abdominal pressure, such as chronic coughing, sneezing or constipation, should be avoided and care should be taken in post operative period to immediately treat them so as to have good vaginoplasty results.
Patient satisfaction rate is usually good and surgery is usually successful in all the females
Team of highly qualified doctors- Dr Deepti Asthana is an internationally trained gynae cosmetic surgeon whereas Dr Ashish Khare is an experienced plastic and cosmetic surgeon.
Each patient gets individual personal attention and care.
Clinic set on high standards with great ambience.
Well trained staf.f
Clinic equipped with latest state of the art technology and equipment.
Innumerable happy patients and great past results.
All safety measures for COVID 19 are being followed:
Clinic is being sanitized daily.
Screening of medical staff and patients at the entrance.
Social distancing being strictly followed.
Surgeons are equipped with recommended PPE kits.