Candidate for Vaginoplasty?
Doctor Answers 8
Lost all sensation after childbirth.
Thank you for your question. I am sorry you are having difficulties. The symptoms you describe of pain and your pelvic floor becoming filled with air are symptoms of pelvic organ prolapse. This is when the organs of your pelvis drop down through your vagina. This can include your bladder, intestines, rectum and uterus. Evaluation by a pelvic floor reconstructive surgeon (FPMRS) would be the next step. Repair will depend upon what is dropping out. Vaginal laxity can be repaired as well. The vaginoplasty tightens the canal of your vagina. The perineoplasty tightens the opening. I hope that helps. Good luck!
Candidate for Vaginoplasty?
Candidates of Vaginal Rejuvenation or Vaginoplasty surgery are women who desire a more youthful appearance and function of the vulva and vaginal area. For some women, the effects of childbirth, aging, trauma, and/or genetics, causes their vaginal tissue and muscles to become stretched, which results in loss of strength and tone in the vaginal area. This may result in decreased intimacy and sexual satisfaction. In some cases, the laxity of tissues can be visible.
The lining of the vagina can be reduced, removing excess and redundant mucosa decreasing the diameter of the canal. The muscle ring, pubococcygeus, at the entrance or introitus can be tightened. These procedures along with exercises such as Kegles can help keep the muscle tone in this area. Aesthetic Vaginoplasty, in many cases, can increase friction during intercourse, giving women more control of vaginal muscles, increasing sexual satisfaction, while also creating a more attractive and appealing appearance to the vaginal area.
The best thing is to schedule consultation with a board certified plastic surgeon to discuss the options of the vaginoplasty or other vaginal reconstructive or rejuvenation surgery that may help achieve your desired results.
Too Loose, Vaginoplasty or Perineoplasty
Thank you for sharing you question and concern with us. Based on your description it does appear you have prolapse to some degree of your vaginal tissues. The extent and which compartments of the pelvis are affected and to what degree is impossible to elucidate via this type of forum. In fact the only way for you to reliably obtain the information you seek is to present to a cosmetic gynecologist/urogynecologist adept at complete pelvic reconstructive techniques and surgeries, not just the "cosmetic external ones" to fully assess what "defects" may be present and what level of repair to help you attain your goals. Be well.
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Post-delivery anatomical and other changes
Thank you for your question. Your description indicates that you may have both, anatomical changes secondary to vaginal delivery as well as other ( non-anatomical ones). As far as the anatomy is concerned, a surgical correction should restore to a significant degree both, the appearance and the function. In order to accomplish it, a reconstructive procedure is recommended including Vaginoplasty, Perineoplasty, Posterior Perineorrhaphy if Rectocele is also present. Frequently, multiple layers of sutures are utilized to adequately restore the anatomy and function of this area. As far as one of the aspects you addressed ( " does this mean that my issue is not due to "being loose"? ") is concerned, other factors may affect the different experience after vaginal delivery. It could be the surface of the vaginal epithelium ( more stretched), the quality of the connective tissue, or simply a "new life" with a newborn/infant/baby. Keep in mind, in case you would consider another pregnancy, the anatomy and function may change again but at this time, a thorough reconstructive procedure could be of a significant benefit for you.
Yvonne Wolny, MD
"Am I a candidate for perineoplasty? For Vaginoplasty??
From your description, a combined posterior colporrhaphy/vaginoplasty/perineorrhaphy/perineoplasty would be perfect. For this, you'd need to see a trained & experienced "Cosmetic gynecologist"or "cosmetic urogynecologist" who can work both on the inside & outside, tightening, getting rid of the hernias, re-building the perineal body, and effecting a "cute" aesthetic repair for the outside. This CAN be done, but you need to see the "right" experienced surgeon! Also, be prepared to WORK at the right vaginal exercises after your surgery.
Michael P Goodman, MD
Davis, CA, USA
Non-surgical options beyond Kegal exercises are very limited in their long-term efficacy, especially if there is a mechanical defect such as an episiotomy incision that was improperly are inadequately closed after childbirth.
Your story and concerns are in good company with almost ever other patient that undergoes vaginal rejuvenation. Based upon your photos, your anatomy as well is very typical of someone who seriously considers having these procedures and turns out to be an enormous (sexual) self-confidence booster thereafter.
Again, like most other surgery, the experience of and “attention to detail” (a.k.a. compulsiveness) by the surgeon is the most important element to achieving a good result. Although there is some merit to Kegal exercises, many patients with laxity after natural vaginal birth fail to obtain sufficient tightening. For these patients, vaginoplasty, tightening of the vaginal vault muscles from the introits (opening) up to the cervix is typically the best solution. The procedure is commonly done on an outpatient basis in about an hour under either deep intravenous sedation or general anesthesia. Recovery is gradual but probably the worst for the first 4-5 days until swelling starts to reside then patients feel better each day thereafter. Sexual activity is usually refrained for about 6 weeks. In a study I was involved in back in 2009, 87% of vaginoplasty patients were satisfied with their results and had an improved sexual experience post-operatively. Typical (all inclusive) fee at my office/surgery center is $8500. Glad to help.
Is vaginoplasty the solution for you?
You have the classical symptoms of vaginal laxity. You may also have damage to the vaginal and pelvic supports. You need to be examined by an expert in pelvic reconstruction as well as vaginoplasty because a combination of both might be needed to achieve adequate and long lasting vaginal tightening. Perineoplasty will not be enough. It only tightens the outer muscles. Your problem involves both the outer and the inner muscles. Anyone who tells you otherwise or tries to steer you to try a nonsurgical machine of any type for the symptoms you describe lacks expertise. Feel free to contact me privately for more info. I manage out of town patients on a regular basis.
Many women have decreased nerve innervastion after a prolonged pushing in labor. There are nerves that can be traumatized. Have your OBGYN examine you.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.