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

Helo Carmensita,
Sorry to hear about your difficulties. You should consult with an experienced reconstructive vaginal who specializes in vaginal rejuvenation. Go to the link below to see the many treatments available for sexual dysfunction. From that link you can schedule a virtual consultation via phone or zoom, at which time we can discuss in depth your symptoms, expectations and concerns. Women from all over the world travel to my Center for their Intimate Makeover.
Best of luck,

Thank you for your question Vaginal lubrication is actually plasma that enters the vaginal canal with engorgement of the vascular with excitation. When vaginal tissue is removed there is less surface area to transfer the plasma and therefore less moisture. Radio frequency procedures like Thermiva increase blood supply to the vagina and may help. Otherwise there are many lubricants that can used to mimic natural lubrication..

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.

hello, the bartholin glands, which make up the lubrication after the operation, may be damaged. Unfortunately, this is irreversible, but you can benefit from mesotherapy into the vagina.

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

This is a "bad news, good news" situation. If you are well pre-menopausal (under 40 years old), then the sudden-onset dryness may be secondary to removal of the Bartholins glands at ~ 4 and 8 o'clock at the opening of the vulvar vestibule & vagina. That's the "bad news," and cannot be reversed. But do not freak: you can counter this by applying a generous amount of coconut oil, light vegetable oil, or silicone ersonal lubricant to both your lover's penis (if male...) and to yourself (more fun if he does this part!) Voila! Adequate lubrication. If however you are perhaps approaching menopause, the dryness may be due to a combination of decreasing intra-vaginal lubrication and a natural diminishment of Bartholins lubrication with age. In this case, why are you now all of a sudden noticing it? When you were "loose" and a bit "open" the dininishing lube was not big-time noticable, but now that you are "built-up" and "tighter," you notice... The "good news? Make an appointment with a Gyno who is savvy and interested in helping you with lubrication and improvement of lovemaking. This can be in person or "virtually." This person can help with diagnosis and an array of treatment modalities. You will want someone who understands both your surgery and is interested in helping with it. If it is "peri-menopausally related, a combination of estradiol or estriol intra-vaginal cream or inserts, plus outside lube as per above will help. Hope this is helpful. Our office does this type of work with patients...

Regards! Michael P Goodman, MD, FACOG, IF, AAACS. Female Genital Plastic/Cosmetic Surgeon and Sexual Medicine Practitioner, Davis, CA, USA