Vaginal tightening surgeries are performed to increase the pleasure of sexual intercourse in male and female partners, eliminating the problem of vaginal width and related complaints. It is also called “vaginoplasty”. As with any surgery, vaginal tightening surgery has some risks and complications.
The risks and complications in vaginal tightening surgery can be classified as early, middle, and late terms.
Bleeding and hematoma (bleeding into the tissue) are among the most crucial complications experienced in the acute period (in the first 24 hours) after vaginoplasty operations. Bleeding may be abundant, especially in patients with vaginal varicose veins. Sometimes, slight but prolonged bleeding (oozing) can also be seen due to the activation of the subcutaneous open vessels. Abundant bleeding that drains outward or accumulates under the skin and may lead to a hematoma is rare.
Early term risks;
On the other hand, there are risks such as bowel injury in posterior wall vaginal narrowing and urinary bladder injury in anterior wall vaginal narrowing operations.
The mid-term risks of vaginal tightening surgery include the complications;
The wound dehiscence is usually more frequent in the perineum (between the vagina and anus),where the tension is most significant. Sometimes, annoying bleeding in the form of slight leakage can be observed for up to a week.
Among the late-term risks of vaginal tightening surgery;
These cysts develop due to the burial of the upper skin under the skin during the surgical operation. Inclusion cysts are benign cysts, also known as 'epidermoid cyst', 'epidermal inclusion cyst', 'infundibular cyst', 'keratin cyst'. These cysts, which settle under the skin, can continue to exist without symptoms for many years, and they can become infected and abscess. Inclusion cysts are benign cysts, and they do not become cancerous.
One of the common mistakes is that the "perineum" region, located between the vagina and anus, is raised excessively, and the vaginal entrance is narrowed too much. The wider the incision made to the perineum in the first stage of the surgery, the higher the perineum will rise. This makes sexual intercourse extremely painful, sometimes even impossible. Painful intercourse can also lead to the problem of iatrogenic vaginismus, which manifests itself with involuntary vaginal contractions over time due to negative conditioning.
The perineum is a sensitive area, so it should not be stretched more than necessary or raised, and blood circulation should not be impaired by frequent and tight sutures or aggressive electro-cauterization. The same is true for the simultaneous removal of perineal skin folds in labiaplasty operations.
Hard scar tissue that has lost elasticity due to poor wound healing in the perineum can cause tearsor lacerations after every sexual intercourse. After tearing and bleeding, which is a concern for patients, delicate “granulation tissue” will form in that area, but this tissue may be torn by re-traumatization in the subsequent intercourse. In this case, either the scar tissue will need to be surgically removed, or PRP or regenerative hyaluronic acid injections will be required to heal the tissue with bad collagen.
Pain and pleasure during sexual intercourse are like two pans of a scale. As the pain increases, the pleasure will decrease, the arousal will decrease, the vaginal lubrication will be replaced by vaginal dryness, further increasing the pain in a vicious cycle. In time, the emergence of the problem of sexual desire loss due to ‘negative conditioning’ will be inevitable. If there is a sexual pain or arousal problem in patients who have vaginal dryness after vaginal tightening, they should be treated.
Tightening of vagina should be determined in accordance with the patient's demands and anatomic conditions. It should be more in those who have too much relaxation problem, and in cases where the enlargement is less, it should be less. In this regard, the medical history given by the patient is also important. The width of the patient's spouse's penis also determines the amount of narrowing.
Copyright 2023 Assoc. Prof. Süleyman Eserdağ, MD. All Rights Reserved. Legal Warning