What is Repair?
Repair stands for reparation. And in this context, it refers to a reparation of vaginal area that might become flaccid as a result of childbirth. There are two methods of vaginoplasty which are:
Posterior Vaginal Wall Repair – the incision will only be made in the posterior area of vagina, in the same position as C-section incision. This method is use in mild vaginal prolapse.
Both Posterior and Anterior Vaginal Wall Repair – the incision will be made at both front and back of vagina. This operation is often used in patients who have given birth more than two times or those who have vaginal prolapse. In the past, this method was also employed in solving Urinary Incontinence condition.
Surgeon will examine vaginal condition and determine the appropriate operation accordingly, however, as the surgery is considered partly for aesthetic, patient would still be the one who makes the final decision. Most of the patients decide to do repair because of their partner. In any circumstance, patient is required to go through vaginal examination to ensure that they do not have any disorders such as, abnormalities of the uterus, pelvic and ovaries, or any tumor. Patients are recommended to treat all the abnormalities before doing the surgery. Just like nose augmentation, vaginoplasty is not a necessity but a choice. Unless the condition intervenes with patient’s daily life or sex life, it is a matter of personal preference.
Age Ranges of Vaginoplasty Patients
Age of vaginoplasty patients ranges from late twenties to seventies, while the most common age range is around 35-45. The younger patients are more likely to be those who have given birth to a child, and the older patients usually have urinary problem as a result of prolapsed vagina.
Does having many sexual partners cause the prolapse?
In the opinion of gynecologists, it is not the main factor of the symptom, however, many patients focus on this factor as they believe that sexual activity can cause vaginal prolapse. Technically this is partly true as sexual intercourse can cause some tearing of tissues, but it does not significantly change the shape of vagina in any way. Personally, we do not recommend the surgery to patients who decide to do repair for the mentioned reason.
Preparation for the Surgery
If possible, patient should check if they have cervical cancer or if any of their congenital disease would affect the surgery. For example, patient should consult with their general doctor before surgery if they have diabetes.
Prior to the operation, patient should abstain from food and drink for 6 hours, as well as stop taking some medicines and supplement such as birth control pill or Vitamins, as these might cause bleeding during surgery.
Post anterior repair will take about 45 minutes, while reparing both sides will take about 1 hour 30 minutes. The recuperation period for the post anterior repair is about 2-3 days to 1 week and patient can return home right after the surgery. For repair of both sides, patient is required to be admitted to the hospital for 4 days, after which they can return home.
Vaginoplasty is a little different from other kinds of surgeries as the surgical wound will be constantly in contact with vaginal discharge, and in some patient with excessive Leucorrhoea there might be bacteria or fungus. This does not yet consider that the wound is situated very close to the area where wastes are excreted. For this reason, the surgical wound requires special care and hygeine as there is a higher risk of infection around the area. Unlike other kinds of surgeries that surgeons would recommend patient to move around after the surgery to prevent fibrosis, in vaginoplasty, patient should avoid moving as it might cause blood clotting. In the first 2-3 days, avoiding movement supports healing of the wounds significantly.
Treatment After Surgery
After the surgery, patient can clean their body as normal. If the vaginal discharge gives off strong odor, patient can try sitting in warm water before going to bed. This will help clean the blood left from the surgery which fosters bacteria growth. The doctor will make another appointment after 6 weeks to check on the recovery, after which patient can continue their daily life with regular vaginal examination schedule.