Vulvovaginal surgery encompasses specialized surgical interventions addressing functional, medical, and aesthetic concerns of the female external genitalia and vaginal canal. These procedures are performed by gynecologic surgeons with specialized training in reconstructive and cosmetic gynecologic surgery.
Common Indications for Surgery
✔ Functional discomfort during intercourse or daily activities
✔ Congenital abnormalities affecting anatomy
✔ Postpartum changes causing structural laxity
✔ Oncologic resections for vulvar/vaginal cancers
✔ Aesthetic concerns impacting self-image
Primary Surgical Procedures
1. Labiaplasty (Labial Reduction)
Reshapes enlarged or asymmetrical labia minora
Addresses discomfort from irritation or chafing
Typically outpatient procedure with local/general anesthesia
Recovery: 2-4 weeks with restricted activity
2. Vaginoplasty (Vaginal Rejuvenation)
Tightens lax vaginal tissues
Improves sexual function post-childbirth/aging
May include pelvic floor muscle repair
Recovery: 4-6 weeks with pelvic rest
3. Vulvar Reconstruction
Corrects defects from trauma or cancer surgery
Treats lichen sclerosus complications
Often combines excision with flap techniques
Recovery varies by complexity (weeks-months)
4. Clitoral Hood Reduction
Reduces excess tissue covering clitoris
Enhances sensitivity and appearance
Frequently combined with labiaplasty
Recovery: 2-3 weeks
Specialized Medical Procedures
For Pelvic Organ Prolapse
Posterior/anterior colporrhaphy
Vaginal vault suspension
For Cancer Treatment
Radical vulvectomy
Lymph node dissection
For Congenital Conditions
Vaginal agenesis correction
Imperforate hymen repair
Surgical Approach & Techniques
Minimally Invasive Options
Laser-assisted procedures
Radiofrequency treatments
Traditional Methods
Cold knife excision
Electrosurgical techniques
Anesthesia Choices
Local with sedation
General anesthesia
Recovery & Postoperative Care
Immediate Post-Op (First Week)
Ice packs for swelling
Pain management protocol
Limited ambulation
Weeks 2-4
Gradual return to light activities
Sitz baths for comfort
Follow-up wound checks
Long-Term Care
Pelvic floor therapy
Scar management
Sexual activity restrictions (4-6 weeks)
Risks & Considerations
Potential Complications
Bleeding/hematoma formation
Wound healing issues
Altered sensation
Asymmetry (in cosmetic cases)
Success Factors
Surgeon experience (>50 cases/year ideal)
Appropriate patient selection
Realistic outcome expectations
Choosing a Surgeon
Key Qualifications
✔ Fellowship-trained in FPMRS or cosmetic gynecology
✔ Hospital surgical privileges
✔ Before/after portfolio review
✔ Clear communication of risks/benefits
Red Flags
Promising “perfect” results
Pressuring for unnecessary procedures
Lack of detailed informed consent
Frequently Asked Questions
Q: Will insurance cover my procedure?
A: Medically necessary surgeries (e.g., cancer reconstruction) often qualify, while cosmetic procedures typically don’t.
Q: When can I return to work?
A: Desk jobs: 1-2 weeks; Physical labor: 4-6 weeks.
Q: Will I lose sensitivity?
A: Properly performed surgeries preserve nerves, but temporary numbness may occur.
Q: How long do results last?
A: Structural repairs typically permanent; aging may cause gradual changes.
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