Bladder Lift and Vaginal Wall Tightening Same As Vaginal Rejuvenation?

Is bladder sling and vaginal wall tightening for cystocele repair the same as "vaginal rejuvenation?" What is the difference between the two procedures? Is there a difference between seeing a urologist or a cosmetic surgeon for this problem? Would a cosmetic surgeon be more likely to address tightening, specifically tightening of the walls and entrance? Should one follow up with a cosmetic surgeon after working with the urologist? Is the result of the bladder lift and wall repair procedure actually tighten the vagina the way I read that the vaginal rejuvenation procedures claim to do?

Doctor Answers 4

Vaginal rejuvenation and tightening with bladder lift or cystocele repair

You have asked some excellent questions that are confusing to most patients contemplating the procedure.

Understanding this process requires understanding the anatomy as well.

So excuse me if this sounds to simple. The front or anterior wall of the vagina is the posterior or back wall to the bladder neck; this is similar to a two story building and saying the ceiling of the first story is the same as the floor of the second story. In the same way the posterior or back wall of the vagina is the front wall of the rectum.

A weakness in the front (anterior) wall of the vagina causes a cystocele (bulging of the bladder into the vagina) whereas a weakness in the back (posterior) wall of the vagina causes a rectocele (bulging of the rectum into the vagina).

Most cosmetic or gynecologic surgeons when performing a vaginal rejuvenation will tighten the posterior wall also called a posterior repair. However, a cystocele repair is completed on tha anterior wall of the vagina. Both will make the vagina smaller. However, the posterior repair tends to be more secure because it is supported by a tightening of the muscles as well (levatorplasty). These are not usually performed at the same time.

A vaginal rejuvenation or posterior repair will tighten a sigficant portion along the length of the vagina. A perineoplasty will repair or tighten just the opening to the vagina.

Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Bladder Lift & Cystocele Repair vs Vaginal Rejuvenation

Slings are designed to provide support to the bladder neck as a treatment for urinary leakage. Slings do not tighten the vagina at all. Cystocele repairs sometimes involve a mild tightening of the anterior wall of the vagina, but offer no significant vaginal tightening that you would notice during sex. Vaginal rejuvenation tightens the muscles and skin of the posterior wall of the vagina and the perineum to reduce the caliber of the vaginal canal. Slings and cystocele repairs are done by gynecologists, urogynecologists and urologists. Vaginal rejuvenation can be performed by all of the above if they have been trained in these procedures. The same goes for cosmetic surgeons.

Marco A. Pelosi III, MD
Jersey City OB/GYN
4.7 out of 5 stars 26 reviews


We are now in a world of subspecialized medicine. There are (fortunately? Unfortunately?) different doctors for different procedures. The problem is when some doctors (who have training in one area) try to branch out and claim expertise in another area!
For aesthetic surgery in the labia minora you are best suited to see a plastic surgeon or GYN with specific training in aesthetic vulvovaginal surgery. For bladder issues and for cystocele surgery, best to be seen by urogynecologists or gynecologists with expertise in that area.

Adam J. Oppenheimer, MD
Orlando Plastic Surgeon
4.9 out of 5 stars 200 reviews

Vaginal Rejuvenation vs Bladder lift

Good question. The short answer is that a bladder lift or "suspension" elevates the lower bladder ("neck") to its former position to prevent leaking, incontinence. 
A Vaginal rejuvenation procedure narrows or tightens  the vaginal muscle for increased sexual pleasure. 

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 157 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.