I had a partial hysterectomy, anterior and posterior vaginal repair 9 months ago and feel as loose as before surgery?

I had a partial hysterectomy and posterior and anterior repair 9 months ago. I could tell the difference for the first 5 months while having sex and so could my boyfriend. Within the last four months it feels like my vagina is as loose as before surgery and my boyfriend notices the difference also. I am completely discouraged that I had the procedure for nothing. If this surgery didn't work what will?

Doctor Answers 7

Wrong procedure

Thank you for your question. It is very difficult to give you an opinion as I'm not sure on the reasoning why you had a partial hysterectomy alongside an anterior-posteriorvaginal wall repair.     These are usually performed for pelvic floor dysfunction and not necessarily to tighten the vagina. 
I would consider a consultation with a cosmetic surgeon to discuss a vaginal tightening procedure

Santa Monica OB/GYN
5.0 out of 5 stars 27 reviews

What can I do if my vagina is loose a year after vaginal reconstruction?

There is a difference between surgery to fix a cystocele and rectocele and a vaginoplasty to tighten the vagina.  It is unclear why you have loosened up in a way that causes sexual dissatisfaction but I suspect your original surgery was to correct the prolapse and not to tighten your vagina for sexual intercourse.  I would consider trying an office procedure called a thermiva before any corrective surgery.  This is a painless procedure that takes thirty minutes to perform.  Typically this is performed monthly for three months.  Patients notice improvement immediately and are very pleased.  

Michael Litrel, MD, FPMRS, FACOG
Woodstock Urogynecologist
5.0 out of 5 stars 4 reviews

You didn't have vaginal tightening surgery

Neither hysterectomy nor anterior and posterior repairs are intended to tighten the vagina. The latter two procedures are specifically designed to repair damage to the vaginal walls, but not to tighten the muscles. Vaginoplasty is designed to tighten the vaginal canal and it can be done during anterior and posterior repairs. You can certainly have a vaginoplasty if you want vaginal tightening afterwards.

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

Hysterectomy & anterior-posterior repairs ARE NOT sexual enhancing vaginal tightening operations!

A hysterectomy plus A & P repair are operations performed by every general Ob/Gyn physician and ARE NOT SEXUALLY RESPONSIVE VAGINAL TIGHTENING OPERATIONS!! So sorry, but if your doc told you it was, he or she was not being truthful. If you just "thought" that this surgery would make you "tighter" & feel more friction you have been poorly informed. These operations (obviously) remove the uterus that was causing you significant problems in some way (otherwise, why remove it?!), and are what are called "site-specific" repairs, that is to "fix" herniations of the bladder and rectum to help with problems such as involuntary loss of urine and defecation problems. The operations you had were not the "vaginal rejuvenations" performed by the relatively small handful of us who are truly sexually savvy pelvic floor support surgeons.

BUT, THERE IS HOPE! FInd a gynecologist or urogynecologist who is a pelvic floor specialist and can PROVE to you he/she has either significant experience (many cases) or has been SPECIFICALLY TRAINED and specializes in doing the procedures of "perineoplasty" and "vaginoplasty" specifically for vaginal tightening and increasing sexual pleasure and orgasmic response. You'll have to look around, may have to travel, and insurance WILL NOT pay for it (if a doc says "insurance will pay" for your specialized vaginal tightening, that surgeon WILL NOT be doing the operation you want.) In performing a true vaginal tightening vaginoplasty I, and other similarly skilled surgeons dissect higher, suture the "Kegel's muscles" (the levators) together over the midline, cover them with strong fascia, remove all the fibrous scar tissue from childbirth along with some fat and connective tissue, build up the muscles and significantly draw the sidewalls of the vagina together. If your surgeon also trains you in the skill of performing ongoing pelvic floor strengthening exercises, ONLY THEN will your vagina be tighter and, as the muscles are strengthened, STAY TIGHTER onward in time! All of the surgeons so far answering your question here are well trained and have patients fly in from all over the country and overseas because of their experience & expertise.

The weblink below, as well as several other areas of the website will give you additional answers.

Best wishes,

Michael P Goodman MD
Davis, CA, USA

Why didn't the results of my hysterectomy with anterior and posterior repair 9 months ago last?

Dear Robinls,

Thank you for writing in with your excellent question.  Sometimes when women have vaginal surgery, it is not performed adequately.  The surgeon needs to be both knowledgeable and experienced in identifying the specific damage in the birth canal and know how to fix it.  Re-approximating the muscles and the fascia as well as re-supporting the structures that need it are essential to good and lasting results.  It is also possible, it was done correctly but did not hold for some reason.  You certainly can have a second repair which, if performed by a trained surgeon, should give you the results you are looking for.

Research surgeons who are highly experienced in vaginal rejuvenation surgeries and pelvic reconstruction and get two opinions before having another surgery if you decide that is the right option for you.  You may also want to consider the new non-surgical, no downtime, in -office radiofrequency treatment called ThermiVa, which uses heat to shrink the vaginal tissues and improves sensation as well as bladder function (if one has leakage of urine with coughing, sneezing, or an over-active bladder).  With the laser and radiofrequency options, 3 treatments are needed and about a once a year for maintenance, so like Botox and fillers, it is not a permanent solution.

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

I hope this information is helpful.


Dr. Troy Robbin Hailparn
Cosmetic Gynecology Center of San Antonio

Troy Hailparn, MD
San Antonio OB/GYN
5.0 out of 5 stars 34 reviews

Partial repair?

If your surgery was for looseness, it is very likely that your partial hysterectomy included only a partial vaginal repair with merely the outer 1/3 of the vaginal barrel tightened. Remember, though, this is a type of "hernia" caused by your tissue weakness usually after childbirth and weak tissue can give way again. You should talk to your OBGYN about the extent of the repair and get guidance.

Lawrence Eisenhauer, MD
Encinitas OB/GYN
5.0 out of 5 stars 2 reviews

AP repair - didn't work

Dear Robinls

I am sorry to hear of your situation but did you actually have vaginal rejuvenation?  Just because a surgeon performs an anterior and posterior repair does not mean they tightened your vagina.  There are many surgeons offering vaginal rejuvenation but they really don't understand pelvic floor reconstruction.  So first we need to understand did your surgeon : 1) perform rejuvenation 2) correctly diagnose you with all the prolapse they fixed (I see all too many times a surgeon performing anterior and posterior repair yet the patient has uterine and vaginal vault prolapse too---- if this is true this needs to be fixed to to give vaginal tautness)  3) is your surgeon truly experienced in vaginal rejuvenation or 4) perform the necessary procedures but it just didn't work for you?

Even the most experienced surgeons do NOT have 100% success. If the surgeon tells you do then you need to find a new surgeon.  My partner and I have been performing rejuvenation for 16 years and the most common problem is the surgeons are not experienced performing them.   In our patients if there is a failure of the surgery it can usually be performed a 2nd time with success.  I encourage you to find a surgeon who truly has experience.

Choosing a cosmetic vaginal surgeon  or any surgeon should be one of the most important decisions of your life. Failure to choose a surgeon with experience, expertise and one who achieves excellent results is not easy find. There are a lot of surgeons who think they are experts in the field but they don’t work on vaginas daily. Some surgeon have practices that allow them to operate and perform: breast augmentations, tummy tuck, butt lifts, hair transplant and then there are surgeons who dedicate their whole practice to vaginal reconstruction and cosmetic vaginal surgery. It is obvious which surgeon has more experience, expertise and better insight as to the a patients desires of their gynecologic area. Please don’t just choose a surgeon because they claims to be specialist in plastic surgery --- choose a surgeon who can prove to you they are specialists in your gynecologic area of concern. The gynecologist and reconstructive vaginal surgeons ( i.e. urogynecologists) with cosmetic vaginal surgery training are usually the surgeons with the most vaginal reconstruction experience.

John R. Miklos, MD, FPMRS, FACS
Atlanta Urogynecologist
5.0 out of 5 stars 20 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.