Safety, Efficiency, and Outcomes of Perineoplasty: Treatment of the Sensation of a Wide Vagina

Abstract

Background. The sensation of a wide vagina is a common problem for women after childbirth. As its etiology is unknown, there is no uniform management strategy. We hypothesized that, rather than vaginal laxity, the cause was level 3 pelvic support deficiency. Methods. This retrospective study compared preoperative and postoperative genital hiatus length, perineal length, and total vaginal length in patients treated with perineoplasty for the sensation of a wide vagina. A telephone survey was used to determine postoperative patient and male partner satisfaction rates. Results. Mean age of patients was 48 (26–68) years; mean body mass index (BMI) was 25.3 (17.6–33.2); and mean parity was 2.5 (2–5). Preoperative and postoperative genital hiatus, perineal length, and total vaginal length were 4.62 and 3.18 (p < 0.01), 3.06 and 4.04 (p < 0.01), and 9.43 and 9.43 (p = 0.882), respectively. At the 6-month follow-up, the success rate of the perineoplasty procedure was 87.9%; according to a visual analog scale, partner satisfaction rate was 92.6%. Ten percent (n = 4) of patients said they experienced dyspareunia during sexual intercourse at the introitus of the vagina. Conclusion. With low dyspareunia rates, low complication rates, high patient satisfaction, and satisfactory anatomical success, perineoplasty can be considered successful for treatment of the sensation of a wide vagina.

Perineorrhaphy Compared With Pelvic Floor Muscle Therapy in Women With Late Consequences of a Poorly Healed Second-Degree Perineal Tear

“…Ulubay et al described anatomical changes, patient satisfaction and sexual function in 38 women undergoing perineorrhaphy due to "a sensation of a wide vagina". 111 The patient satisfaction rate was 88% in comparison to 80% in the per-protocol analysis of the patients who underwent perineorrhaphy in our study. Christmann-Schmid et al published a study of 121 patients undergoing posterior repair where preoperative perineal anatomy was categorized into three groups; normal perineum, short perineum and high/overcompensated perineum.…”

“…Ulubay et al described anatomical changes, patient satisfaction and sexual function in 38 women undergoing perineorrhaphy. 111 In this study patient satisfaction rate was 88% and a total of four patients (10%) reported de novo dyspareunia postoperatively. Pardo et al performed vaginal wall repair and perineoplasty in women with the sensation of a wide vagina and reported a patient satisfaction rate of 96% at six months after surgery.…”

The clinical role of LASER for vulvar and vaginal treatments in gynecology and female urology: An ICS/ISSVD best practice consensus document

“…The term VLS and therefore its therapy, vaginal rejuvenation, is not endorsed or formally defined by the leading gynecological societies . However, management of the symptoms have evolved from techniques involving sutures and the adaptation of traditional urogynecological procedures to the use of LASER and radiofrequency procedures …”

“…11 However, management of the symptoms have evolved from techniques involving sutures and the adaptation of traditional urogynecological procedures to the use of LASER 61,90 and radiofrequency procedures. [91][92][93][94][95][96][97][98][99] In 2011, there was an attempt to restore the rugae of the vagina in postmenopausal women ("vaginal rugation rejuvenation"), by vaporization of the vaginal wall in order to create parallel grooves. The procedure was performed in women with a sensation of a loose or smooth vagina.…”

Vaginoplasty and Perineoplasty

“… 3 The few studies that have been done show that vaginal tightening procedures, including vaginoplasty and perineoplasty, are associated with improved sexual function with low complication rates. 1 – 4 Reported complication rates include inadvertent rectal entry of 2% and minor complication rates with no long-term sequelae ranging from 3.8% to 19.7%. 3 …”