Will vaginoplasty address urine and rectal prolaspe?
Doctor Answers 4
Rectocele and stress incontinence can be addressed at time of vaginoplasty
Rectal prolapse or rectocele?
Rectal prolapse is not the same as rectocele. The first is a prolapse of the entire rectum through the anus. The second is a bulge of the rectal wall into the vaginal canal with nothing happening at the anus. Rectal prolapse is treated with rectal resection and/or fixation - it's major surgery done through the abdomen or through laparoscopy. It has nothing to do with vaginoplasty. You would want to have this done first. Vaginoplasty simply tightens the vaginal canal. It is not designed or intended to improve urinary leakage.
Candidates for Vaginoplasty. Cost of Vaginoplasty
Hello Friend from Folsom,
While I would need to examine you in person to assess your individual anatomy and give you viable options for your individual situation, I will answer you basically below...
I'm not sure exactly what you mean by "rectal prolapse.' If you mean that the rectal mucosa is prolapsed through the rectal opening, the repair is a procedure separate from pelvic floor reconstruction, and one that is performed by a colorectal surgeon. But, if you mean that there is a large "bulge" produced by the rectum pushing or "herniating" through the floor of the vagina with a "pushing our" vagianl opening bulge, this is a situation that may be repaired along with a pelvic floor support operation ("posterior repair/posterior colporrhaphy") which may be performed by a Gynecologist or Urogynecologist. Unfortunately, however, the huge majority of Gyn's and Urogyn's are not trained in the propritarily-named operation, "Vaginoplasty," which alludes to the overall tightening of the vaginal barrel for the express purpose of enhancing sexual function and orgasm, or in the skill of aesthetically reconstructing the vaginal opening. For that, you would need to see a "Cosmetic Gynecologist" who also has reconstructive skills, or talk your network Urogynecologist into being mindful of your sexual and aesthetic desires...
As relates to your incontinence, again, this would need individual evaluation. While a "sling" procedure is "standard-of-care" for moderate to significant incontinence, you very well may be well-treated by a pixillated fractional CO2 Laser treatment to the upper vagina or an "anterior colporrhaphy," both of which would also tighten the far upper vagina. So far as the surgical venue, in my hands I perform virtually all my vaginal tightening operations (perineoplasty; posterior colporrhaphy; vaginoplasty) in my office surgical suite under local anesthesia which feel is safer, less expensive, and better performed in the patient can "show" her surgeon her vaginal muscle bundles during surgery by being awake enough to contract her muscles... Post-op physical therapy of the pelvic floor, which should be incorporated int any good vaginal rejuvenation program will lead to greater longevity of your repair.
Michael P Goodman MD
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Vaginoplasty for rectal prolapse and urine incontinence
Your story and concerns are in good company with almost ever other patient that undergoes vaginal rejuvenation and turns out to be an enormous (sexual) self-confidence booster thereafter.
Vaginal Rejuvenation (a.k.a. vaginoplasty) is performed to reconstruct (more or less tighten) the vaginal vault most commonly following natural vaginal birth. 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.
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