Please help! Vaginal canal feels loose & lax, how could I correct this? (Photos)

Question

Is anyome able to help me by this pic? What conditon do i have and how can I go about correcting it? Background info - vaginal canal feels very loose and lax. Had two babies vaginally Tried several different non surgical treatments and kegals and they did not help. Is this my uterus prortruding? Thanks in advance!!

Mark N. Scheinberg, MD · Answer

THANK YOU FOR YOUR QUESTIONYes, you can be helped. To understand what needs to be done, you need to understand the anatomy.  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. Be aware that once these are repaired you should not have another vaginal delivery so if you get pregnant again you will need a caesarian section. Do your homework and research well looking at reviews and before and after photos. Better to have it done right the first time.No, it is not the uterus protruding but rather appears to be prolapsing of the rectovaginal mucosa.

George Shashoua, MD · Answer

Thank you for reaching out, based on your photo it appears that you do have some degree of prolapse, which is a relaxation of the vaginal walls. It is likely that your vaginal deliveries played a large roll in contributing to the relaxation. In some patients, non surgical treatments and kegels do help, but this is all dependent on the amount of relaxation present. If you have tried conservative measures without any improvement in symptoms, surgical intervention may be indicated. In order to determine what type of prolapse you have and what surgical options may be appropriate I recommend seeking evaluation with a board certified urogynecologist. Based on your exam your surgeon will recommend a treatment plan to address your specific concerns.

Stephanie Molden, MD · Answer

It is difficult to tell what kind of tissue is seen at the vaginal opening. Most likely it is a small posterior bulge of vaginal tissue consistent with a small rectocele from childbirth. If you experience laxity symptoms, vaginoplasty surgical correction would fix both issues and has a good success rate. I would suggest a co summation with a surgeon experienced in both urogynecology and cosmetic gynecology. We offer virtual consults for out of town patients as do others.

Mehmet Bekir Sen, MD · Answer

Hello,
Thank you for reaching out with your concern about vaginal laxity . This is a common issue many women face, generally after multiple vaginal deliveries. You're not alone, and there are solutions available.
Non-surgical treatments and Kegel exercises can offer some improvement, but they may not always provide the desired tightening effect, particularly for those who have experienced significant stretching or tearing during childbirth. In such cases, surgical intervention, such as Vaginoplasty or Vaginal Tightening Surgery, may be a more effective option.
Vaginoplasty is a surgical procedure that aims to "tighten up" a vagina that's become slack or loose from vaginal childbirth or aging. This is achieved by removing excess vaginal lining and tightening the surrounding soft tissues and muscles. The procedure generally has a good track record for improving vaginal tightness, sexual satisfaction, and overall self-esteem.
Another option is Laser Vaginal Tightening, which uses laser technology to tighten the vaginal canal by stimulating collagen and elastin production. While less invasive than surgery, it may require multiple sessions and the results may not be as long-lasting as surgical options.
It's imperative to consult a genital aesthetic surgeon for a comprehensive assessment and to discuss the most suitable treatment options for you. Because, sometimes there may be a bladder prolapse problem, then bladder recovery surgery may be required. (if urinary incontinance problem has occured) Vaginal tightening procedures should be personalized based on your anatomy, medical history, and desired outcomes. 
For further reading, you may consider searching for terms such as "Vaginoplasty," "Vaginal Tightening Surgery," or "Laser Vaginal Rejuvenation."
Thank youDr Mehmet Bekir SENGenital Aesthetic Expert

James Haley, MD, FACOG, FPMRS · Answer

Thanks for your inquiry. Your situation of looseness  is very common with women after vaginal deliveries. Surgery is indicated to resolve your issue. If you plan on having more children you may opt to wait if you are not experiencing discomfort. I recommend a consultation with an advanced cosmetic gynecological surgeon. 
Hope this helps!

Michelle Jones Singer, MD · Answer

I suggest you have a gynecologist exam to determine if you have a prolapsed uterus. An option that you can consider is  a vaginoplasty. The vaginal canal is tightened during a vaginoplasty, a surgical treatment for vaginal rejuvenation. Typically, a perineoplasty is used to tighten the vaginal opening through surgery. By enhancing the friction and fullness sensations, these procedures improve sexual function and pleasure. They also make the vaginal entrance look better. Consult an experienced cosmetic gynecologist or urogynecologist for an examination.

Lori Warren, MD · Answer

Your vagina looks completely normal. Have you had vaginal births, if yes, normally our vagina stretches and does not always return to its complete previous state. It is normal to have some laxity after vaginal delivery. I do not see any evidence of your uterus or anything else protruding, but a vaginal exam is necessary to determine if you have any prolapse of any kind. You do you have many options for vaginal tightening, some are non-surgical and some are surgical. Schedule an appointment with a cosmetic gynecologist for a full consultation. I hope this helps.

Marco A. Pelosi III, MD, FACOG, FACS · Answer

The vagina feels loose because childbirth loosens the muscles by damaging them and by damaging the vaginal supports (aka the pelvic floor). Nonsurgical treatments don't work because they don't fix the damage. Kegel exercises don't work because the muscle supports are broken. The only way to fix your problem is with a vaginoplasty which repairs all of the muscles. However, it needs to be combined with pelvic floor reconstruction which repairs the damaged pelvic floor -otherwise the muscle repairs won't hold. I recommend that you begin with a virtual consultation to gather more information about your goals and expectations followed by a live consultation to exam the extent of damage that needs to be repaired.

Burcak Tok, MD · Answer

It is very difficult to make a clear diagnosis with the picture, there may be urinary bladder, bowel part and uterine cervix that may protrude through the vagina. The treatment for all of these is surgery. If non-surgical procedures are applied for vaginal looseness and there is no improvement, it is necessary to surgically remove sagging and vaginal tightening with vaginoplasty procedure.

Mona Hardas, MD · Answer

Hi , thank you for submitting the pictures. For vaginal wall laxity and to diagnose the condition correctly you will need a proper gynecological examination. The pelvic floor muscles support the bladder, uterus as well as rectum and you can get prolapse of any of these 3 organs. From your pictures it looks like there is a bulge in the posterior vaginal wall which could be Rectocele or uterine prolapse. Some times after child birth there is excessive vaginal skin protruding out which may look like a prolapse but is just extra skin from stretching during labor etc. This can be very easily corrected with vaginoplasty procedure. In this procedure we will tighten the pelvic floor muscles, trim the extra vaginal skin and make the opening of the vagina narrow so you will not feel looseness and laxity. It is a office based procedure done under local anesthesia. I will advice you to contact cosmetic gynecologist for a proper diagnosis and see if you a a candidate for vaginoplasty. Good luck and call us if you have any questions.

Please help! Vaginal canal feels loose & lax, how could I correct this? (Photos)

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