Why does vaginal tightening ("Vaginoplasty") work? (Part 1)

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Evolutionary Biology, large penises and vaginal tightening surgery

An article from Stuart Brody’s group at the University of Paisley in West Scotland in the Journal of Sexual Medicine (JSM) a couple of years ago continues to stir controversy, and is actually directly related to one of my own personal research areas: Why, physiologically and biomechanically, does vaginoplasty surgery work so well? Why does genital plastic/aesthetic surgery (Labiaplasty and Vaginoplasty) improve sexual function in women? In a recent Letter to the Editor in the JSM, Erin Crabill, a sex researcher from Pennsylvania further discusses the article and suggests additional research avenues.  In the original article, the authors present research exploring the hypothesis that larger penises provoke vaginal orgasms during penile-vaginal intercourse (PVI). They believe cryptic female choice is responsible for the evolution of larger human penises. The authors also conclude that direct sexual experiences with female preference for larger penises, not stereotypes in popular culture, are responsible for the male belief that women desire larger penises.

The authors state that orgasm during PVI is evolutionarily advantageous, as it encourages vaginal intercourse. If true, women who achieve vaginal orgasm would have a reproductive advantage, and the majority of females would now be capable of vaginal orgasm (a fact not presently corroborated in the majority of women.)  The authors further believe that the male desire for a larger penis stems from sexual experience rather than from cultural stereotypes or media influence.  Ms. Crabil goes on to state that she doubts that women are turning men away mid-coitus on finding a smaller-than-average penis, or ending a relationship due to small penis size. She suggests ideas for further research which might include information on the length and size of subjects’ vaginal canals, as this is likely to be an indicator of penis size preference.

So, you may ask, just how does this all relate to genital plastic/cosmetic surgery? Very directly. Orgasmic pleasure in a woman is, as physicians are fond of saying, “multifactorial.” The biggest sexual organ both men and women possess is of course between their ears: relationship, fantasy, mood, availability, desire all enter in. That said, as I have written previously (Do Sex Researchers Really Have This Much Fun..?? October 13, 2013,  and “Vaginal Tightening and Orgasms, Part 2, Jan. 29, 2014,  there are most likely two distinct types of orgasm, clitoral and vaginal, and the deep, throbbing vaginal orgasmic experience is directly related to the amount and degree of vaginal stretch, pressure and friction brought to bear on erotic autonomic nerve receptors in the vagina, mostly in the nerve-rich area corresponding to the so-called “G-Spot” in the anterior vaginal wall, but also to receptors in the cervix and elsewhere in the vaginal walls. Any surgical procedure which narrows the vaginal barrel and especially elevates and strengthens the vaginal “floor” so that the penis is “thrust” more tightly and directly against the vaginal walls and anterior vagina in particular would, like a larger penis, be expected to elicit a greater sexual response; a “tighter vagina” thus having the same effect as a larger penis.

Additionally of course, If the perineum/vaginal opening/perineal body is well elevated, bulked and strengthened as it is with a properly performed vaginoplasty/perineoplasty procedure, the dorsum (upper side) of a man’s penis (as well as his pubic bone) is placed in more direct contact with the external clitoris, and aids in production and intensity of clitoral orgasm as well. Voila!

Article by
Davis OB/GYN