Vaginal Surgery

                 This article addresses the sensitive topic of the anatomical changes that can occur in women after childbirth and the physical and emotional effects it has on women and their relationships. I will then touch on diagnosis and treatment.
When a baby comes out of the vagina many muscles have to stretch to accommodate the fetal head. Unfortunately, not all the muscles return to their pre-delivery state. This lack of return to pre-delivery tone can be due to:

A. Tearing of tissues with inability to heal
B. Improper repair of lacerations in the vagina
C. Inadequate healing of tissue because of activity
D. Repeated trauma from multiple births
E. Birth of an excessively large baby, > 9 LBS.
F. Health conditions that inhibit healing such as diabetes and tobacco.
G. Genetically inherited traits of poor healing.

             Symptoms of vaginal trauma with poor healing vary from involuntary loss of urine or stool to abnormal connections between the vagina, bladder, and colon. These patients might complain of stool or urine coming out of the vagina. Another common symptom from many women is the like of sensation of the penis entering the vagina during intercourse. For many women, part of sexual orgasmic function is the sensation of vaginal resistance prior to the entry of the penis. The complaint from women and men is not being able to tell if the penis is in the vagina because of lack of vaginal tone. Many patients find this topic difficult to discuss because of social restrictions on sexuality. Most women are relieved that I start the discussion after a routine exam and get rid of the barriers to a healthy discussion.

             After proper diagnosis, treatment can involve non-surgical treatment such as intensive vaginal exercises. Many women, however, require vaginal surgery to reconnect attachments in the vagina that were interrupted after birth. This vaginal surgery is usually covered by most insurances and is often outpatient surgery, allowing women to get back to work activity fairly soon.

             One of my specialties in Obstetrics and Gynecology is vaginal reconstruction. I am able to tell patients in one visit if they have a problem and how it can be corrected. I also focus on lifestyle changes that allow the repair to last forever. Patients need to make sure they see a doctor with excellent surgical skills because poor technique can result in procedures that need to be corrected or can result in a vagina with excessive pain with intercourse.