Bladder prolapse and vaginoplasty

Vaginoplasty typically is focused tightening the vaginal canal and opening by conducting muscle repairs internally along the levator ani and externally at the perineum (repair of this area is called perineoplasty). The work is done along the posterior vaginal wall because that's where these structures are located. Rectocele repairs are done as part of these operations routinely because the muscle repairs will fail without them. Cystocele repairs aren't usually done because they have no appreciable effect on vaginal tightening. If you have a symptomatic cystocele that requires surgical correction, however, it can be repaired at the same time. If you wish to discuss specifics, schedule a virtual consultation.

Hola! si, en la misma cirugia podemos corregir el prolapso, laxitud y tambien hacer el rejuvenecimiento vaginal al mismo tiempo, puedes irte el mismo dia a casa si asi lo desea . Quedamos a la orden, feliz dia

Thank you for your questionVaginoplasty originally meant making a new vagina but since the term is “ vagino-plasty” any surgery in the vagina can be called vaginoplasty and each surgeon has their own idea of what they call vaginoplasty so you would need to know what they are including.The vagina is connected on six sides ( entrance or orifice, apex, two sides, anterior or bladder side, and posterior or rectal side). Each of these need to be addressed to achieve optimal results. If you have four children you would most likely need to address the anterior,posterior and orifice. The most effective method is called “ site specific defect repair “. Do your research as many surgeons are doing different things and calling them vaginoplasty. Look at reviews and before and after pictures. Question them on what technique s they use and how they approach the repairs.

Hello, and thank you for your question.
For bladder prolapse, the correct surgical treatment is a cystocele repair, which is a different procedure from a vaginoplasty. Vaginoplasty tightens the vaginal canal by addressing the muscular and fascial support inside the vagina, but it does not directly correct the bladder’s descent on its own.
If you already have a bladder prolapse, even if it is mild, it should be evaluated separately. In cases where symptoms such as:a bulge or pressure sensation in the vaginapelvic heavinessdifficulty emptying the bladderurinary urgency or stress leakagefeeling of looseness due to loss of anterior wall supportare present, a cystocele repair is recommended in addition to the vaginoplasty.
So yes, if you want a complete and long-term solution, the bladder prolapse repair would need to be performed as an additional procedure at the same time.
Best wishes,Dr. Mehmet Bekir ŞenGynecologistGenital Aesthetic Surgery Specialist, Istanbul

Stage 1 bladder prolapse, especially after multiple childbirths, can contribute to a feeling of vaginal laxity even without major symptoms like incontinence. Vaginoplasty can tighten the internal vaginal walls and improve muscle tone. If there’s an existing prolapse, even a mild one, it usually requires a separate but often concurrent procedure such as an anterior repair to support and reposition the bladder properly. Some surgeons may offer a combined approach if both issues are present, but it’s not automatic. It’s important to discuss both concerns clearly during consultation so the surgeon can assess the extent of the prolapse and determine whether an additional repair is needed alongside the vaginoplasty to fully address your symptoms and prevent future complications.

Hello, in the vaginoplasty operation performed for vaginal width, bladder prolapse is not corrected. A separate operation is required for bladder prolapse. However, the two procedures can be performed in the same session.

Vaginal laxity can come from the top of the vaginia, side walls and floor. Correcting with a vaginoplasty can narrow and correct a vaginal prolapse. However, if it involves the bladder, that may be a separate procedure to correct.

If you’re undergoing a vaginoplasty for vaginal tightening, we always assess for any signs of pelvic organ prolapse both during your consultation and again at the time of surgery.

Rectocele (posterior wall prolapse) is typically addressed and repaired as part of a vaginal tightening procedure. However, if the prolapse involves the bladder (cystocele or anterior wall prolapse), this usually requires a separate procedure and is not automatically included in a standard vaginoplasty.

That said, both repairs can be performed during the same surgical session if needed—this would be discussed and planned with you ahead of time.

Q: Will vaginal reconstruction (vaginoplasty) correct cystocele?

A: "Vaginoplasty" is a term commonly used in cosmetic gynecology, but it is medically defined as the creation of a vagina de-novo when it is absent. This is a complex issue that requires further explanation. The urinary bladder is supported not only by the anterior-distal vaginal wall but also by its own suspensory and supportive structures; therefore, vaginal reconstruction (vaginoplasty) alone will not resolve bladder prolapse. Clinical assessment and imaging must confirm the site-specific defects within these supportive structures before surgery. These defects can be corrected using native tissue to reposition the urinary bladder. Surgical mesh is unnecessary as native tissue can be effectively utilized. Several anatomical regions need the restoration of the bladder's supportive and suspending structures.

Vaginal Reconstruction
This procedure must follow the principles of site-specific defects reconstruction instead of using a generic repair for the vaginal wall. Under no circumstances should vaginal tightening be offered, as it involves resecting the posterior vaginal wall and partially removing the posterior perineum (crotch). Such procedures can result in urinary and fecal incontinence due to unintentional damage to the perianal body.

All the best,
Prof. Dr. Adam Ostrzenski
Florida, USA