Vaginoplasty

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Vaginoplasty
& Pelvic Floor Reconstruction
Cystocele | Rectocele | Enterocele

Vaginoplasty is the surgical tightening of the skin and muscles of the vaginal canal from the outside to the inside when they have become loose - a condition called vaginal laxity. It is the gold standard procedure for vaginal tightening. It provides the strongest and most durable results of all available treatments. The terms vaginoplasty and surgical vaginal rejuvenation are sometimes used interchangeably. Laser vaginal rejuvenation is a specific type of vaginoplasty. Regardless of the technique, the results of a vaginoplasty are dependent upon a well-supported and intact pelvic floor. Since many women have a pelvic floor that is damaged from childbirth, the repair of this damage is integral to a successful result. The repair of a damaged pelvic floor is termed pelvic floor reconstruction. Drs. Pelosi have extensive training, education and experience in all elements of these procedures and include any necessary pelvic floor reconstruction when they conduct vaginoplasty procedures to ensure you the best possible results.

The Vaginal Muscles: The Outer Muscles

The outer layer, just beneath the skin, is called the perineum. This layer primarily provides support to the vagina.

The muscles of the perineum form a partial ring around the vaginal opening. The majority of this ring consists of the left and right bulbocavernosus muscles.

The center of this ring is a fusion point where the bulbocavernosus muscles connect with the transverse perineal muscles. This fusion point is called the perineal body.

The outer vaginal muscles are not the muscles involved in Kegel exercises and women are not usually able to tighten them at will. However, when they are intact and firm they generate a snug yet elastic sensation during intercourse.

The Vaginal Muscles: The Inner Muscles

The inner layer of vaginal muscles responsible for vaginal tightening are called the levator ani muscles or simply the levator muscles.

The levator muscles form the floor of the pelvis and support the bladder, the vagina and the rectum during normal activity.

These muscles consist of one large sheet of muscle tissue that spans across the entire bony pelvis with an opening in the center called the levator hiatus or the genital hiatus.

This sheet of muscle is shaped like a bowl with the levator hiatus at its center.

The periphery of this bowl is attached to its surroundings by a tough layer of leather-like tissue called fascia.

The center is attached to the tailbone and the perineal body.

The Puborectalis Muscle

The central portion of the levator ani muscle group is called the puborectalis muscle (blue). This muscle loops around from front to back and forms a sling that tightens around the vagina, the bladder and the rectum.

When the puborectalis muscle contracts, the gap between the two sides constricts and the vagina tightens.

Vaginal childbirth can damage the puborectalis muscle by either damaging its nerve supply or by loosening its attachments. Once damaged, the muscle is unable to contract properly and the ability to tighten the vagina is lost or impaired.

The puborectalis muscle is the target of vaginal rejuvenation tightening procedures.

Pelvic floor reconstruction is integral to a successful vaginoplasty.

Pelvic and vaginal structural components are frequently broken, not merely loosened from childbirth. This can cause conditions known as cystocele, rectocele and enterocele. Pelvic floor reconstruction techniques restore essential support. Your clinical exam will determine whether your vaginplasty requires these techniques.

If you are seeking nonsurgical vaginal tightening, click here>

Cystocele

This is the technical name for a loose, sagging or dropped bladder. Urinary incontinence is frequently a side effect. The condition most commonly begins during vaginal childbirth when the fetal head stresses and tears the lateral attachments of the bladder to the surrounding musculature along the anterior vaginal wall. Corrective surgery may include sling procedures of the bladder neck and repair of the lateral bladder attachments (paravaginal repairs).

Rectocele

The posterior vaginal wall is also prone to damage from the forces of childbirth. The most common consequence injury to this area is a bulging of the posterior vaginal wall and rectum into the vagina through damaged tissue planes (endopelvic fascia). In some women, bowel movements may be affected by this bulging and require digital pressure through the vagina for complete emptying.

Enterocele

Damage to the vaginal apex deep behind the cervix (the cul-de-sac) produces bulging of the vaginal wall and the internal pelvic lining (peritoneum). The appearance is similar to a rectocele, but originates deeper along the posterior vaginal wall. Low back pain is a common symptom of this condition.

Out of Town Patients

Many patients at LVR-NJ travel considerable distances for our expertise in this procedure. We facilitate this process by providing the option of same-day consultation/same-day surgery. This is arranged in advance and by request at the time that you contact our office. Pre-operative bloodwork testing will need to be performed in advance through a local physician or lab near your home. Drs. Pelosi will review your situation to determine if this is an appropriate option. If you fly, or if your drive home is more than 2 hours, we recommend that you stay in the area overnight after your surgery so that Drs. Pelosi can evaluate you for proper healing on the day after surgery; afterwards, you may travel home. In certain situations, we can provide you with an overnight stay the night before your surgery if you are arriving late in the day.

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