Dryness after vaginoplasty/perineoplasty. Is there any way to reverse this procedure or tips to get the wetness back?

Question

I was very wet before the surgery., it’s been over a year and I have a very difficult time getting wet or starting wet since the procedure and now I am regretting my decision. Is there any way to reverse the procedure or any tips on what I can do to get the same wetness I did before surgery?

Mark N. Scheinberg, MD · Answer

Thank you for your question Most "wetness" is actually blood plasma pushed across the vaginal surface which is a function of the blood supply to to the vaginal tissue(mucosa). The amount depends on the surface area of vaginal tissue. When you have vaginal reconstruction , excess vaginal tissue is removed reducing the surface area of the mucosa thereby reducing wetness. The way to improve wetness is by increasing blood supply. A way of doing this is radio frequency treatment e.g. Thermiva or laser e.g. Mona Lisa. Both these increase blood supply to the vagina and can improve wetness.

Mehmet Bekir Sen, MD · Answer

Hello Kristin,
I'm sorry to hear about the challenges you've been experiencing since your surgery. Changes in vaginal lubrication can be concerning, and I understand your distress.
Firstly, it's important to note that changes in vaginal wetness can be influenced by various factors, including hormonal changes, stress, certain medications, and of course, surgical procedures. Every individual's response to surgery is different, and sometimes, post-operative changes can affect the natural lubrication process. 
While it may not be possible to completely reverse a surgical procedure, there are several options we can explore to help improve vaginal lubrication and your overall comfort:
One of them is Topical Estrogen Therapy: If hormonal changes are contributing to dryness, localized estrogen treatments can be effective in restoring vaginal moisture. (We definitely recommend this treatment after the examination, if necessary.)
Lubricants and Moisturizers: Vaginal lubricants and moisturizers can provide immediate relief and are helpful for maintaining vaginal moisture.
Hydration and Diet: Adequate hydration and a balanced diet can also play a role in improving overall vaginal health.
Laser Treatments: Vaginal laser therapies, such as the FemiLift or similar treatments , can help rejuvenate vaginal tissues and improve moisture.
Hormonal Assessments: A thorough evaluation of your hormonal levels might provide insights into any underlying issues that could be addressed.
Counseling and Therapy: Sometimes, psychological factors or medicines can influence physical responses of the body , and counseling might be beneficial.
I encourage you to consult with a specialist who can provide a comprehensive evaluation and tailor a treatment plan specific to your needs. In Turkey, where I practice, we have a range of advanced treatment options and technologies to address issues like yours.
Best regards,
Dr. Mehmet Bekir ŞenGenital Aesthetic Surgeon

Burcak Tok, MD · Answer

Hello, I do not know if the bartholin glands, which provide moisture, were damaged during the operation, but if you experience a lot of dryness after the operation, veginal PRP, mesotherapy or laser treatment may be beneficial for you.

Lori Warren, MD · Answer

I’m sorry to hear of your troubles. However, vaginoplasty should not decrease vaginal moisture. Vaginal moisture has a lot to do with our age and hormone levels. It may be because you were in a natural stage of your life that would’ve been decreasing vaginal moisture, that just so happened to coincide with the timing of your vaginoplasty. You should look into assessment of your hormonal levels. It could be that you just need some balancing or optimizing of your hormones in order to get the moisture back. We also offer a number of treatments with laser resurfacing or radio frequency micro needling for vaginal moisture for patients who desire that type of treatment. I hope this helps.

Oscar A. Aguirre, MD, FPMRS · Answer

Hello Kristin,
There is not reversing your vaginoplasty, but there are ways of improving your lubrication. Your options depend on the etiology of your poor lubrication. You should consult with a gynecologist to help you determine the cause and your treatment options.

Michael A. Reed, MD · Answer

Vaginal dryness after vaginoplasty is caused by one of two things.  The first is over correction at the introitus to tighten and lift the perineum, resulting in blockage of the opening of the Bartholin's gland.  The Bartholin's glands are responsible for lubrication at the vaginal opening.  If the dryness is only at the opening of the vagina then the cause is most likely due to your operation. If however, you experiencing full length dryness of the vagina, then the most likely cause is GSM (Genitourinary Syndrome of Menopause) which is easily treated with vaginal Estradiol.  In any event, an in person exam is warranted.  Best of Luck! Michael A Reed MD Davis CA @thecosmeticgyn

Michael P. Goodman, MD, FACOG · Answer

Yours is not an unusual query. I have several patients with whom I work successfully with to re-establish the moisture. You say that you were "...very wet" prior to surgery, but now [uncomfortably] dry. Here is why: If the dryness is from loss of that lovely slimy clearish vaginal opening coating that happens with sexual arousal to pre-menopausal women, then your dryness may have resulted from a "vigorous" emoval of opening tissue upon reconstruction, which may have resuted in removal of your Bartholin's Glands, which are responsible for releasing that lube. If the dryness is loss if lubrication INSIDE the vagina (but moisture at the opening OK,) then this is likely secondary to ( pre-menopausal) hormonal changes, Obviously the treatment differs depending on the cause.

I suggest that you consult, either personally or "virtually" with an experienced practitioner savvy about treatments for this situation to see which would suit you best: external lubricants (and exactly which kind), or intra-vaginal hormonal therapy (estrogen or DHEA...)

Best wishes for success,

Michael P Goodman, MD, FACOG, IF, AAACS
Davis, CA, USA

I suggest that you consult, either personally or "virtually" with an experienced practitioner savvy about  treatments for this situation to see which would suit you best: external lubricants (and exactly which kind), or intra-vaginal hormonal therapy (estrogen or DHEA...)

Best wishes for success,

Michael P Goodman, MD, FACOG, IF, AAACS
Davis, CA, USA

Burcu K. Arslan, MD - Account Suspended · Answer

Hi ,there may be many reasons for vaginal dryness. After your examination we can do much more specific treatment but after the surgeries we can use laser treatment and vaginal PRP just for rejuvenating the vaginal canal . And this may help your symptoms.

Dryness after vaginoplasty/perineoplasty. Is there any way to reverse this procedure or tips to get the wetness back?

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