UTI’s and dryness 3 years post vaginal + perineum tightening. Unable to get answers from doc who performed surgery. Options?

Lubrication during arousal and sex is mainly via the Bartholin glands. The openings to these glands are close to the area typically involved in the tightening of the perineum. The exact position of these openings varies slightly from woman to woman. So, if your gland openings were affected by the perineum tightening, that might be the source of your problem. There is no way to restore the gland openings. You would need to use lubricants.

Q: Can vaginal dryness be restored?

A: Yes and No!

Yes, because if there is only Bartholin glad obliterated opening(s), then micro corrective surgery can restore the function of this anatomical structure(s).
Please remember that vaginal lubrication comes from many sources, such as the uterine cervix, vaginal wall permeability, Skene’s glands (periurethral ducts), and Bartholin glands. Therefore, it is a complex clinical issue, and experts can only establish the definitive clinical diagnosis and eventual treatment.

No, because if postsurgical scarring is too deep and vaginal walls are affected beyond repair, or nerves are damaged. There is hope in this case, and you do not have the luxury to postpend the diagnosis and eventual treatment.

It is a fundamental question, and not answering it but using RealSelf to increase popularity is unfair.
Dr. Marco Pelosi III elaborates on the Bartholin glands as a significant cause of vaginal dryness and informs readers: " There is no way to restore the gland openings.” It is far away from the current medical-surgical knowledge, and the procedure is available. Yes, it is possible to reinstitute Bartholin’s glad duct function, and I usually use a surgical loupe for this micro-operation. Also, Dr. Pelosi’s video does not answer the question that is asked here and presents a surgical approach to the gaping vaginal orifice.

Dr. Michael P. Goodman advises in his writing about using vaginal lubricants, which does not answer the question here. In the video, Dr. Goodman markets marketing for existing devices, including radiofrequency (RF) and laser equipment. Neither RF equipment nor lasers were subjected to adequate clinical-scientific studies to determine safety and effectiveness. Moreover, in 2018, the US Federal Drug Administration (FDA) issued the WARNING about not applying a laser to the vaginal wall. Dr. Goodman, as a RealSelf advisor, you should not deceptively inform women about using lasers without informing women about these devices’ potential harm. The FDA issued a warning based on numerous adverse event reports (vaginal burns, deep vaginal scarring, pain during sexual intercourse, and chronic pain). Furthermore, the FDA provided information that deceptive marketing of unproven treatments might prevent women from receiving appropriate medical care. Dr. Goodman, such advice offers is dangerous, and suggesting a laser for application in vaginal plastic therapies is irresponsible, playing with women’s health, and incompetent advice.

With regards,
Prof. Dr, Adam Ostrzenski