I am looking for any solution for my wide vagina, I did an A-P repair operation but results only last few months, suggestions?
Doctor Answers 9
Thank you for posting this important issue. An A/P repair repairs only the bulging bladder and rectum. It is the perineorraphy which helps to bring the perineal body and bulbocavernosus muscles together and narrow the diameter of the vagina. See a Urogynecologist/Female Reconstructive Surgeon for this. A university center would be the best place to start your search, and your surgery may be covered by insurance depending on the extent of the muscular damage.
There are many reasons and repairs for vaginal "looseness"
Thank you for sharing your question and concerns with us. It always saddens me when someone has a feeling of hopelessness in the face of a legitimate concern. Rest assured this is not a hopeless situation and seeking a second opinion from a well qualified pelvic reconstructive surgeon will go a long way for you. Why? Not all gynecologists/urogynecologists have the expertise to remedy the problems you are expressing. Why? The pelvic cavity is a very complex set of organs and tissues that all interact and work in concert with each other to achieve normal function. As such there are various "compartments" that all have to be addressed as to which are damaged, prolapsing/bulging, weak, gaping etc. Rarely is the solution a couple of stitches to tighten something, this all to frequently will lead to either a surgical failure or creating additional problems kind of like a "domino effect". This is why an in person consultation with an expert in the myriad of repairs available will help to remove your sense of helplessness. Be well and best wishes as you move forward.
What can I do for a wide vagina?
There is a difference between an A and P repair and a vaginoplasty and perineoplasty. Some degree of vaginal tightening is accomplished with the repair of pelvic organ prolapse. But the anatomy is not restored to the level it was before vaginal births or sexual activity. Repair of pelvic organ prolapse and repair of vaginal laxity require specialized surgery. You can certainly have this issue addressed if you desire. I would seek consultation from a Female Pelvic Reconstructive surgeon who specializes in tightening surgeries for evaluation.
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An A-P repair is not a vaginal tightening operation
An A-P repair is designed to add support to the vaginal walls when they are sagging. It is not designed to tighten the vaginal canal for better sex. There are several types of A-P repairs which add support in different ways, but none of these repairs incorporate tightening of the vaginal muscles which is the key to a tight vagina. Your ob-gyn can't do anything more for you because she isn't trained to do anything more for you. I recommend that you seek out a specialist in both vaginoplasty and pelvic reconstructive surgery. Feel free to contact me privately if you are considering travel for such expertise.
Still loose after an A/P repair?
Hi SRWA, I am very sorry to hear of your situation...unfortunately it not an uncommon complaint following these type of repairs. The bottom line is this, and we tell our patients this on a daily basis, an A/P repair done by a general gynecologist is NOT a vaginoplasty or a vaginal rejuvenation procedure that is completed for laxity or sexual dysfunction (such as looseness, less sensation w/ intercourse, less friction etc) resulting from damage from childbirth resulting in laxity and/or prolapse and damage to the perineal body. An Anterior/Posterior repair is a gynecologic procedure that is designed ONLY to treat a cystocele and rectocele, i.e. a defect in the support of the bladder and rectum, and to reduce the bulge and treat the prolapse. Vaginal rejuvenation surgery involves FIRST restoring the support with an A/P repair and then (and this is the part that takes extra years of training, experience and expertise) the vaginal rejuvenation portion of the procedure is completed. This is the portion of the procedure that the muscles of the pelvic floor are brought back into position and the caliber of the vagina restored to the pre-childbirth state. Additionally, a perineoplasty needs to be completed (which many times when done correctly, takes as long as the rest of the procedure) which rebuilds and restores the perineal muscles an the opening of the vagina and restores the tightness at the opening of the vagina. We see many patients that go to inexperienced surgeons (included Board Certified Urogynecologists and Reconstructive Pelvic Floor Surgeons) that have a repair that just tries to tighten the opening of the vagina (doesn't work) or have a vaginal repair of prolapse and they still feel gaping, wide open and have the same sexual dysfunction.
Please consult with a Board Certified Urogynecologist/Female Pelvic Medicine and Reconstructive Vaginal Surgeon that also has extensive experience in vaginal rejuvenation and vaginal cosmetic surgery. I believe your current gynecologist is wrong, i.e. there may not be anything she can do for you, however there is no reason a repair done by an expert vaginal reconstructive surgeon with experience in vaginal rejuvenation cannot get you the results you are looking for. Not only do we have advanced surgical techniques and experience in our hands, we also have the latest technology in stem cells, Platelet Rich Plasma (PRP) and other regenerative medicine techniques that we utilize at the time of surgery that helps enhance our repairs even more.
Please also consider traveling for the procedure as this is a type of procedure that is very amenable for travel and you should not limit yourself to local surgeons that may not have the experience needed.
Best of luck to you,
Dr Robert D Moore, FACOG, FPMRS, FACS
Urogynecology and Cosmetic Vaginal Surgery
Atlanta - Dubai - Beverly Hills
Beware: an A-P Repair from your Gyn or urogynecologist is NOT a vaginal tightening operation nor a "vaginal rejuvenation."
An "A-P repair is a "site specific" repair of herniations of the bladder and rectum into the vaginal canal and is designed as a moderately successful operation to help with urinary incontinence, deficatory problems, and "bulges" into the vaginal canal. While it frequently modestly "tightens" the vaginal canal, it is not specifically designed as a sexually enhancing vaginal tightening and externally aesthetic operation, and unless ongoing pelvic floor exercises ("Kegels"), guided by a pelvic floor physical therapist and/or aided with a biofeedback device (APEX, In-Tone, PeriCoach, etc.) are undertaken, htis operation will fail as a vaginal tightening procedure.
What to do? Research carefully, and find a Cosmetic Gynecologist or Urogynecologist specifically trained in & savvy about specifically designed vaginal tightening operations performed along with perineal strengthening and introital aesthetic repair. Google "vaginoplasty," Vaginal Rejuvenation," and "perineoplasty" and research carefully. Then go in for or arrange telephone consultations. Even though you've had previous vaginal surgery, an experienced surgeon can perform an effective "re-repair." And remember your "exercises! Feel free to navigate the educational website (especially the Blogs) linked below...
Michael P Goodman, MD
Davis, CA, USA
Vaginal looseness after surgical repair
Thank you for your question. After vaginal delivery of three children it is very common for patients to notice vaginal looseness leading to among other things decreased sexual satisfaction for the patient and her partner.
An anterior-posterior surgical repair should have solved the problem. Without another vaginal delivery the repair should have lasted indefinitely with possibly only minimal loosening of the vagina over years. The solution? I would recommend a consultation with an experienced cosmetic gynecologist. At our practice we have seen numerous women with complaints such as yours. A repeat posterior repair using our standard surgical technique has solved the problem in most of these patients.
Too loose too late?
You have a problem and got a strange answer from your OBGYN. Unless the vaginal lining has been cut so short that there is no opportunity for opening and tightening the tissue underneath, this would be an unlikely situation. If the procedure was correct, but your tissue was not strong, you need repair with a foreign material ("mesh" of different sources) to provide you with support, and further tightening. Your OBGYN probably did a good procedure but this loosened because of the tissue reasons that you needed it in the first place. Find another GYN or UROGYN to assess the next procedure value.
I would recommend you see a Urogynecologist or OBGYN experienced in pelvic reconstructive surgery. "Wide vagina" most likely related to pelvic organ prolapse. Sometimes A/P repair is not enough.
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.