In this section, detailed information is given about hymenectomy (surgical removal of the hymen) and hymenotomy (surgical incision of the hymen) for vaginismus problem. In the meantime, the hymen is the name of sexual organ, ‘-tomy’ means the incision procedure and ‘-ectomy’ means the removal procedure.
Anatomical causes compose about 10% of vaginismus. The remaining 90% part is of psychological origin. A simple gynecological examination is very important to determine this situation and clearly diagnose the vaginismus problem.
A gynecological examination is essential for the diagnosis of vaginismus. A simple visual examination that lasts less than a minute allows making a clear diagnosis and determining the degree of the problem.
The first step of vaginismus treatment is the gynecological examination. During the external observation made on the gynecological table, it is understood whether there is a problem about the hymen. Hymen examination is made before vaginismus treatment and outer genital areas are visually examined. The severity of this sexual problem is also determined. The gynecologist should have enough information and experience for accurate diagnosis. Surgical procedures and simple surgical interventions can be made for congenital problems about the hymen.
Hymen structure of every woman can be congenitally different. In these cases, surgical operations can be made to provide a solution.
Congenital anomalies of hymen:
Surgical removal of hymen is called as ‘hymenectomy’ operation. Hymenectomy is performed if the hymen is too hard, thick and high-edged (fleshy). The hymenectomy operation usually takes an average of 15-20 minutes. One month after hymenectomy operation, sexual therapies are started, so the psychological part of the problem will be solved.
For vaginismus treatment, hymenotomy (surgical incision of hymen) can be performed to high-edged but thin hymen types. This operation is called ‘hymenotomy’. Hymenotomy operation usually lasts for 1 to 2 minutes, incisions are made on a few different areas. It is usually made with local anesthesia. However, sedation anesthesia can be required for patients with higher anxiety. One or a few days after the procedure, sexual therapy can be started.
For the treatment of vaginismus, hymenectomy and hymenotomy operations should be performed by experienced physicians. Thus, solution process will be accelerated. Psychological treatment should also be given after hymen surgeries for vaginismus. Because physical problems can lead to psychological problems over time. In vaginismus, it is possible to reach a permanent result only with accurate and scientific methods.
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