Appropriateness for revision?

Lack of tightness and urinary issues after a vaginoplasty require a pelvic examination to assess the anatomy and the quality of the repair. If the exam reveals that the repair was properly conducted, a revision is unlikely to provide benefit and might provoke stenosis. If the exam reveals that the repair was not properly conducted and that there is room for additional tightening, then revision is likely to provide a benefit. Beyond proper technique, factors that affect the quality of the healing are neuromuscular deficits, muscle atrophy and damage, hormonal deficiencies, and impaired bloodflow; some of these can be improved, others not. A virtual consultation would make sense as the first step.

Thank you for your question.YES, REVISION CAN BE PRODUCED IN PREVIOUSLY UNHAPPY WOMEN. BUT YOU NEED TO BE WELL INFORMED.Vaginoplasty literally means plastic surgery of the vagina. It is not a specific procedure (though originally it meant the creation of a new vagina) and every surgeon has a different idea of what technique(s) comprises a vaginoplasty. There is no consensus on which surgical procedure(s) is performed. Therefore , which procedure(s) your surgeon performed will determine the effectiveness of your results. The vagina is like a six sided tube: entrance, apex, upper inside(bladder), lower inside(rectum) and two sides. Each of these needs to be evaluated and has different treatments. My best analogy for understanding what is going on the inside is the steel belted tire which which has a strong support structure (fascia steel belt) and a flexible stretchable surface which has grooves(mucosatread). When the steel belt tears, the tread balloons out increasing the surface area and smoothes out the grooves. This is what is called prolapsing or "an acquired sensation of smooth/wide vagina." There typically are several defects that can occur from childbirth and these can all be corrected best by a procedure called " site specific defect repair".. You need a surgeon who knows how to identify and correct each of the possible defects within the length of the vagina. Also, there can be defects on the entrance(orifice) and apex. These also must be evaluated and repaired. These procedures can be done safely by well trained surgeons but unfortunately most surgeons have learned "anterior and posterior" repair surgery which does not give optimum results for the "acquired sensation of smooth/wide vagina" which is your issue. Find a surgeon trained in "site specific defect repair" and who will evaluate and treat the six sides. There is no reason why you shouldn't be able to get the results you are looking for. but requires you to do your homework, examine their reviews and before and after photos and evaluate the quality of the consult.