Vaginoplasty - how much pressure do you feel under local anesthesia?

Thank you for your questionVaginoplasty technically means plastic surgery of the vagina. Originally It referred to the creation of a new vagina but nowadays surgeons are calling any one of a number of procedures "Vaginoplasty". What can be felt is determined by which procedures are done. The vagina is like a six sided rectangular box ( the entrance ororifice, apex , lateral sides, anterior or bladder/urethra side and posterior or rectovaginal side. Proper repair needs to consider all of these. and can take several hours to perform You need to know which procedure is to be performed, what type of block and local is used. Local anesthesia is designed to protect against pain but not pressure so what people can feel can vary according to individual differences and the above factors. I advise you to thoroughly research the surgeon and check out reviews of their patients that have had this done.

Every woman who undergoes vaginoplasty has a unique tolerance to pain and pressure. This can be predicted by doing a pelvic exam during the consultation. If you cannot comfortably tolerate a pelvic exam during a consultation, you might not do well under local. Keep in mind that the procedure takes 1-2 hours.

Hello, local anesthesia time will vary depending on the size of the surgery to be performed. I prefer general anesthesia for long procedures. However, when it is performed locally in procedures that cannot medically require general anesthesia and will be completed in a short procedure, not much pressure will be felt.

A small handful of Cosmetic Gynecologists are trained and experienced in performing a surgical vaginal tightening operation ("Vaginoplasty + Perineoplasty") under safe, awake, local anesthesia, most trained by the 2 major acolytes of "local vaginoplasty," Drs. Red Alinsod and Michael Goodman. There are several important reasons why "local" is best for Vaginoplasty, and I'll discuss these after I answer your question. While I personally have performed 250 vaginoplasties, over 125 via "local" anesthesia, and have asked and discussed with my patients what they are experiencing, I personally (on myself) have never had this surgery performed, so my answer is from repeated observations only. There is virtually no pain from VR under "local," with these exceptions: 1. Very short-lasting "stinging" from injection of the anesthetic; 2. Transient "Pressure" (like a deep aching/pulling) upon tying the sutures used in rebuilding the vaginal floor; and 3. Occasional transient sharp pulling discomfort during suture placement if the suture "binds" one of the pelvic floor musculature nerves when the suture is tied. If this happens, the surgeon promptly backs out and replaces the suture to a safer place. Overall, the huge majority of my patients do extremely well under "Local," and are happy they chose this route.

So... why choose "Local?" 1. It is safer; 2. Recovery is easier, both immediately, and long-term; 3. (and most important...)- your surgeon can do a better job of tightening & rebuilding, as with you awake (s)he can have you contract your pelvic floor muscles for better identification of the muscle body, and better suture placement into and just beneath the fibrous muscular sheath when re-approximating/rebuilding the vaginal floor. The surgeon is not as timid as (s)he would be under a "General" anesthesia where the surgeon does not know if she/he is compromising a nerve. Under "Local," your surgeon can be more aggressive in your reconstruction, as if a nerve is being compromised, (s)he will immediately know, and quickly re-locate the suture with really only a momentary amount of discomfort.

Overall, in experienced hands, "local" works quite well, and the huge majority of my patients are happy they chose to have their surgery performed under a local anesthetic. RealSelf's web reference below provides additional information...

Very Best for a successful procedure and recovery. Michael P Goodman, MD, FACOG, IF, AAACS.
Sacramento, CA, USA

Best