Why was it necessary to make my vagina smaller when having total hysterectomy and bladder sling placed?
Doctor Answers 4
Not clear why your vagina is smaller
It is very difficult to say why you are having pain without an evaluation. Most surgeons do not understand that mesh can create pain because usually it does not. However we can not make an assumption it is indeed the mesh causing pain in your situation. If it feels like the vagina is too small this might be due to the fact the surgeon shortened the vagina which can happen even in the best surgeons hands. It is also difficult to assess you as we don't really know the exact surgery you had. Some mesh is for cough leakage and this is called a sling which lifts the urethra ( now most doctors will just say we are lifting the bladder but they are just really lifting the urethra) and the other utilized in this area is much larger and has a greater chance of causing pain and this is actually used to lift the bladder. So these are two potential reasons for having pain with sex ( but doesn't mean they are the problem). Another reason is it is possible to shorten the vagina with a hysterectomy.
If the mesh is the problem it will need to be removed. If the vagina is shortened then your vagina will most likely need to be lengthened (Davydov procedure). All of these techniques i.e. treatments can be found on my website. I have removed more than 1000 pieces of mesh in my career but I promise you I would NOT remove it unless we feel >99 % confident it is causing pain. Please investigate you next evaluation wisely. Now it is possible you had more surgery than you are telling us about ( this is very common ) the next doctor is going to need your previous operative report and will need to evaluate you. I doubt the pain with intercourse is due to a lack of lubrication ( this is what the Mona Lisa) is helping to treat as mentioned by others below. Why do I not think this is your problem? Because you would have most likely been suffering from pain with intercourse before your hysterectomy too. You are only 9 weeks out of surgery most women do not lose the effects of estrogen that fast that you would want to rejuvenate using a laser therapy. Now I might be wrong but having operated 1000's of women in my career the most likely reasons for pain will be a direct mechanical effect of the surgery you just had
Best of luck in your care
John R Miklos MD
Urogynecologist & Cosmetic Vaginal Surgeon
Atlanta ~ Beverly Hills ~Dubai
Small tight vagina after vaginal surgery with mesh
That said, here you are. My strong recommendation is for either an in -person or "virtual" (telephone) consultation with a practitioner who is savvy with both vaginal atrophy, sexual medicine, hormonal issues, and working with breast cancer survivors towards healthy, happy, ongoing sexual joy and health after surgical procedures. A PERSONAL consultation is necessary: "one size definitely does not fit all." YES(!), there are several options, including dilatations and laser, but the vaginal opening and vaginal canal must be specifically prepared beforehand. There are several viable options-- find out what suits YOUR NEEDS specifically...
Very best wishes,
Michael P Goodman, MD
Davis, CA, USA
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