Will my vagina be tighter after my hysterectomy (keeping ovaries ) or do I need to ask my doctor I want that done?

Doctor Answers 9

Hysterectomy versus vaginal tightening

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The uterus is an organ that occupies a small space in the vagina. Removal of this organ unfortunately, does not do anything to tighten up the side walls of the vagina or the opening of the vagina. I would recommend that you discuss your concern with your Ob/gyn. Best wishes.

Hysterectomy has no effect on vaginal tightening

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A hysterectomy simply removes the uterus. A total hysterectomy removes the uterus along with the cervix. A subtotal (supracervical) hysterectomy leaves the cervix behind. The ovaries can be removed as an option with either of these procedures. Vaginal tightening can be done at the time of a hysterectomy or any other surgery (tubal ligation, breast augmentation, tummy tuck, etc), but would require special arrangements to cover the additional work, anesthesia and operating room resources.

Vaginal tightening at time of vaginal hysterectomy

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Thank you for your question. Performing a hysterectomy only removes the uterus but does not address the vaginal walls. This can best be achieved at the time of a vaginal hysterectomy. Laparoscopic or robotic hysterectomy cannot address lower vaginal support or restoration of vaginal wall laxity. Even when a laparoscopic hysterectomy is required, your surgeon will still need to approach from the vagina to reconstruct the vaginal walls. Talk with your physician about addressing all of your concerns so that they can be addressed at the same time.

Peter Castillo, MD, FACOG
Bay Area Urogynecologist
5.0 out of 5 stars 16 reviews

Hysterectomies and tighter vaginas

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really depends on if your having a vaginal hysterectomy, and yes you need to discuss this with your GYN.
Don't be shy, just ask and he/she will give you all the information you need

Peter D. Weiss, MD
Beverly Hills OB/GYN

Not Likely!

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A hysterectomy--even one which spares the ovaries--has virtually nothing to do with the muscle tone of the lower vagina (the only part of the vagina that relates to 'tone' and to 'tightness').

There is one exception though: if you are having a vaginal hysterectomy and your surgeon also plans a posterior colporrhaphy (THE operation to reduce the vaginal outlet dimensions) as part of a pelvic relaxation surgery.

If you are having an abdominal/ laparoscopic hysterectomy though, you can expect no changes to your vagina. Be aware that, even though removal of your cervix requires entry into, and trimming/suturing of some vaginal skin, narrowing the upper vagina does nothing for the tone/tightness of the lower vagina.

I urge you to discuss all of the above with your gynecologic surgeon before your surgery date.

Hysterectony=tighter vagina?

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Hello. Thank you for your question. The state of your vagina after hysterectomy depends on a few factors. First, will you hysterectomy be done through your vagina (vag hysterectomy), through an abdominal incision or with the camera (laparoscopic)? Also will it be a supra cervical hysterectomy? If your cervix is removed and/or its done strictly via a vaginal approach, you vagina will be shortened some. This means its length will be shorter but not necessarily tighter. If you are interested in or in need of vaginal tightening you would need to request it. It may need to be done if you have a cystocoele (bladder dropping) and/or rectocoele (rectum pooching into your vagina). Having those repaired will tighten your vagina some. I hope this is helpful to you and wish you well. 
~Dr. Pou

A Hysterctomy does not tighten the vagina

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A hysterectomy removes the uterus with or without the ovaries.  The cervix, where Pap smears are taken, is often removed with the body of the uterus.  Sometimes scar tissue can form at the top of the vagina and can shorten it, and sometimes the use of instruments during surgery can also change how one feels. 

The birth canal needs to be repaired separately from the hysterectomy.  Vaginal Rejuvenation includes seven different procedures to address the different areas of damage due to aging, childbirth and life.  The vagina may have back wall and opening  damage that need to be fixed or the front wall, and side walls too.  The perineum, the space between the vaginal opening and anus, usually needs to be rebuilt to help support the area.  

Troy Hailparn, MD
San Antonio OB/GYN
5.0 out of 5 stars 37 reviews

Will a hysterectomy make my vagina tighter?

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There are different routes in performing a hysterectomy ( Vaginal, open surgery, laparoscopy or robotic ) but all of them do not specifically address any vaginal reconstruction surgery and therefore no tightening of the vagina is performed.  
You may want to speak to your surgeon about your desires and concerns prior to surgery.  It is a great time to undergo a vaginal tightening procedure and you should try and take advantage of that if you need one.
Best of luck!

Request vaginal tightening and seek a second opinon if declined

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Having your uterus removed does not make your vagina tighter. You should ask your gynecologist if he/she will tighten your vagina, but since a vaginal repair isn't part of your current surgical plan you'll likely get declined. Generally, gynecologists will perform a rectocele repair only if you're symptomatic with defecation difficulties. A rectocele repair may result in improved feeling but it is not intended to make you tight like you were before vaginal deliveries.
For a second opinion you should look for a gynecologist who offers vaginal rejuvenation options to their patients. As a fellowship-trained, board certified Urogynecologist and cosmetic vaginal surgeon I've been addressing the functional and aesthetic concerns of patients for many years. Based on your alias of "Basen65" and that you're keeping your ovaries I'll assume you turn 50 years old this year and that you've had vaginal deliveries. If this is the case, I would recommend a detailed history and examination looking at bladder, bowel, vaginal, sexual, and hormonal function before making final recommendations and address all of your concerns in one surgery.
If you have prolapse, such as a rectocele or cystocele, then this could be repaired and a vaginoplasty performed at the time of your hysterectomy. This could be done at the same time as a Labiaplasty or any other aesthetic procedure you desire so you could have one recovery. If you do not have prolapse that warrants surgical repair, then I'd recommend Laser Vaginal Tightening with a CO2 laser, such as FemiLift. Many of my patients are now choosing this less expensive option because it is less expensive, painless and there's no risk of pelvic pain, painful sex or scarring afterwards. Not all patients are candidates for the FemiLift, specially those with a very wide vaginal opening, in this case surgical vaginal tightening with or without a rectocele repair is their best option.
Good luck in your quest for vaginal rejuvenation!

Oscar A. Aguirre, MD
Denver Urogynecologist
5.0 out of 5 stars 38 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.