Vaginal Tightening Surgery; Risks, Complications

Vaginal Tightening Surgery; Risks, Complications

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.

What are the risks and possible complications in vaginal tightening surgery?

The risks and complications in vaginal tightening surgery can be classified as early, middle, and late terms.

Early term risks of vaginal tightening surgery

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;

• Allergic reactions to drugs or anesthetics used
• If the procedure is performed in the office environment and accompanied by local anesthesia, blood pressure reduction due to the vasovagal reflex
• Temporary loss of consciousness (syncope attack) are among the other complications that can be seen.

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.

What are the mid-term risks of vaginal tightening surgery?

The mid-term risks of vaginal tightening surgery include the complications;

• Severe pain spreading to the bowel
• Diffuse edema
• Wound infection
• Opening of the sutures (wound dehiscence)

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.

What are the late-term risks of vaginal tightening surgery?

Among the late-term risks of vaginal tightening surgery;

• Fistulas
• Poorly healing perineum and stiffness in the wound area (scarring)
• 'Inclusion cysts'

What is inclusion cyst?

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.

Painful sexual intercourse after vaginal tightening

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.

Lacerations during sexual intercourse due to vaginal tightening procedure

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.

Vaginal dryness problem after vaginal tightening surgery

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.

How much should vagina be tightened surgically?

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.