Vaginal reconstruction and cosmetic vaginal surgery

Vaginal reconstruction is a general term that refers to surgeries intended to restore the vagina to its original anatomic state. It may involve correcting a cystocele, rectocele or vaginal prolapse (see Pelvic Organ Prolapse. Another anatomic abnormality that can develop with or without pelvic organ prolapse is a relaxed genital hiatus. In this condition a gaping vaginal opening occurs. Vaginal deliveries and episiotomies are the main culprits in its development. Anatomically, it occurs because of separation of the muscle at the vaginal opening (the bulbocavernosus muscle at the area of the posterior forchette).  Women may describe feeling "open". They may complain of lack of sensation during intercourse.

Surgeries for correction of this condition are often advertized in the media under catch phrases such as "Vaginal Rejuvenation" and "Laser Vaginal Rejuvenation". However, the surgery to correct this issue is the standard gynecologic procedure called "Posterior repair" along with a perineorrhaphy (correction of the area between the rectum and the vagina). This procedure is done frequently as part of the correction of pelvic organ prolapse. Urogynecologists have the most training in performing these types of procedures.

Although this procedure brings the anatomy to normal and tightens the vagina it may not affect sensation during vaginal intercourse. Sexual satisfaction  is governed by many factors the most important of which are psychological. Thus multiple modalities of treatment may be needed (Kegal exercises, physical therapy, psychological therapy etc.).

Labioplasty is surgery to change the appearance of the labia, usually the labia minora. People come in all shapes and sizes and all of them are considered normal. Nonetheless, some people chose to change an aspect of their physical appearance with plastic surgery. They do this for all sorts of personal reasons. This trend has also reached the genital area. Some women find their labia too large and choose to have labial reduction. This may be solely due to cosmetic reasons or due to symptoms such as discomfort during physical activity and intercourse. In this minor surgery part of the excess skin of the labia minora is removed achieving the patient's desired appearance.

We at Houston Metro Urology have a multidisciplinary staff from several fields of medicine. We look at all aspects of the patient's problem and offer complete treatment under one roof. This approach enables us to combine cosmetic with standard reconstructive techniques which often allows at least partial if not complete coverage of the procedures by the patient's insurance.