Is my vagina normal? Is surgery the answer? (Photo)

I'm concerned that I may not be as tight as I used to be. Recently I had a baby via cesarean and i'm not sure if pregnancy ruined the integrity of my vagina and/or cervix. I have small amount of urine leakage daily and I don't feel adequate or "tight enough" during intercourse. Is surgery the answer? Are there other ways to fix my problem?

Doctor Answers 12

Non-surgical vaginal rejuvenation

Non-surgical options for vaginal rejuvenations on the CO2RE Intima include improvements to issues with urinary stress incontinence, laxity and excess external labia skin.  Sounds like you would be a good candidate for the Intima treatments and I would recommend a thorough in-personal consultation and pelvic exam to address your unique needs.  Multiple treatments are usually necessary and there is very little discomfort or downtime.Hope this helps.  Good luck. 


New York Plastic Surgeon
4.9 out of 5 stars 72 reviews

Vaginal Tighteness after c section with loss of urine

Thank you for asking. As both a cosmetic surgeon and one that still performs the practice of delivering babies. I come across this exact situation frequently. Although you did not deliver vaginally there are still changes that occur during pregnancy that for many women will lead to changes in the vaginal canal and sometimes lead to vaginal laxicity. It is also very common to experience urinary stress incontinence whereby you may lose urine when laughing, coughing or exercising.Based on what you have described, you are a perfect candidate for a nonsurgical vaginal tightening procedure. We utilize  a fractional CO2 laser called Femilift.   I have performed hundreds of these procedures and have had a tremendous success with outcome and patient satisfaction. This procedure will not only help tighten your vagina but will also help improve your symptoms of urinary incontinence. There is no downtime with this procedure and very little to no pain.

Vaginal rejuvenation

The issues that you are experiencing are quite common especially after childbirth. I would agree with starting with kegel exercises or physical therapy. An exam by your Ob/gyn is important if you concerned about the integrity of the vagina. If you do not see improvement over 2 months with exercises or PT, than a good consideration would be ThermiVa. This is an in office procedure that tightens up the vagina and also helps stop mild urinary leakage. Congrats on the baby and best wishes!

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Vagina tightness after pregnancy

There are surgical options and non surgical as note.  A complete exam is needed as photos do not help

NON-SURGICAL OPTIONS FOR VAGINOPLASTY AND LABIAPLASTY

With the availability of recent technology, there are few nonsurgical vaginal rejuvenation options available for our patients. CO2 fractionated lasers include the FemiLift, MonaLisa Touch and IntimaLase. The ThermiVa as radiofrequency energy that can also treat the outer Labia to reduce and tighten this area.
It can increase blood flow, sensitivity , and orgasm. It can increase moisture and decrease stress urinary incontinence for many women.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Leakage after a baby

Your concerns are well founded.  About 20% of women will experience leakage during and shortly after pregnancy.  With pelvic floor physical therapy (special exercises to decrease leakage an increase strength), this can be rectified.  Talk with your Gynecologist, or seek the advice of a local Urogyne.  If PT doesn't work, then maybe a pessary or surgery may be an option. 

Hope this helps!


Best,

Is my vagina normal? Do I need surgery?

Dear Alag16,

Thank you for writing in about your concerns.  Know you are not alone when worrying about how pregnancy and delivery plus life (aging, gravity) has impacted how your body looks and functions.  Your anatomy looks great from your photo!

You mentioned having a baby recently...Congratulations!  If it has been less than a year then your body still needs to recover from the experience.  Plus are you breastfeeding?  Breastfeeding keeps your body in a higher progesterone, lower estrogen state which negatively affects the bladder and vagina.  How much weight did you gain and how big was your baby? These impacted the pressures downward on the bladder and vaginal canal over time.  

Do you have any other symptoms such as constipation, hemorrhoids, problems with tampons staying in, gas-like noises from air moving in and out during sex, decreased sensation for you (you mentioned) or your partner, or having to rock, apply pressure on the perineum or manually assist in moving your bowels?

Mild to moderate symptoms with mild to moderate pelvic relaxation many times can be managed non-invasively.  When it comes to the bladder, reducing caffeine consumption, losing 5-10 pounds, practicing proper kegel exercises for a limited period of time, and vaginal estrogen (when appropriate) can be helpful.  The newest non-surgical no downtime, in-office treatment for tightening the vagina, improving lubrication and reducing incontinence using radiofrequency is called ThermiVa, and this may be a great option for you.  It takes three 20 minute treatments four weeks apart and you can go back to work, to exercise class or have sex the same day if you felt like it.  ThermiVa increases blood flow, shrinks tissues and improves sensation.  Many of my patients have described improved sensation and bladder function after the first treatment.

You can read more about ThermiVa and other vaginal rejuvenation procedures at the link below.

I hope this information is helpful.

Sincerely,

Dr. Troy Hailparn

Troy Hailparn, MD
San Antonio OB/GYN
5.0 out of 5 stars 26 reviews

Urinary incontinence is not normal, but surgery isn't the only option

Great question! One that I, as a Board Certified Urogynecologist and Cosmetic Vaginal Surgeon, get every day. It's not uncommon to have urinary incontinence after a pregnancy, whether you labored or not, or had a vaginal delivery or cesarean section. Are you currently breast feeding? Any prior history of urinary incontinence? The fact that you also have decreased sensation tells me that you may have some pelvic floor weakness that needs to be addressed.
Non-surgical treatments include: kegels, devices to help with kegels, Physical therapy, vaginal pessary, vaginal estrogen, CO2 Laser Vaginal Ablation with FemiLift, O-Shot with Platelet Rich Plasma (PRP), etc.
You should see your gynecologist or get a referral to a Urogynecologist for evaluation and treatment recommendations.
I hope this helps. Also, look at link below for more information on Urogynecology.
BTW - your vagina looks perfectly normal.
Best of luck,

Oscar A. Aguirre, MD
Denver Urogynecologist
5.0 out of 5 stars 23 reviews

See a pelvic surgeon who also offers vaginal rejuvenation.

Vaginal laxity can occur after childbirth even if you had a cesarean section - but more often if the cesarean section was done during the second stage of labor (after full dilation when the head is inside the vaginal canal).  Often the changes heal by themselves with time, so make sure you wait for full healing.  Your vaginal tissues may also be estrogen depleted if you are still nursing, so that can prolong the healing process and add to your issues.

You may be a good candidate for pelvic floor physical therapy, and your physician may be able to recommend a good physical therapist.  If you are not a surgical candidate and you are well-healed, ThermiVa may be a very good choice for you.  I'm having excellent success with vaginal tightening and mild to moderate stress urinary incontinence with ThermiVa which also has the added bonus of no downtime and an excellent safety record.  This can be done in conjunction with pelvic floor physical therapy since there is no damage to the vaginal mucosa.  

Look for a physician with pelvic reconstructive training who offers vaginal rejuvenation as an option.  

Vaginal looseness

Vaginal looseness with intercourse can be improved with kegel exercises and pelvic floor physical therapy. If more conservtive measures do not work to improve your symptoms, you may be a candidate for vaginal rejuvation or surgical tightening. Often, your symptoms will continue to improve for the first 6 months to 1 year following delivery. It sounds like you would be a good candidate for pelvic floor physical therapy at this point. You can follow the link to read more. 

Do you need a vaginoplasty if you had a cesarean?

Vaginal laxity is usually the result of vaginal childbirth. If you had a cesarean in the second stage of labor - while you were trying to push the baby out for a long period of time and failed, you might also develop vaginal laxity. However, if you had a cesarean and never went through labor, the chance of having vaginal laxity and damage to the pelvic floor sufficient to cause stress urinary incontinence is quite low. Nonetheless, your symptoms would require a gynecologic/urologic evaluation to determine the best course of management.

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.