Vaginoplasty is a surgical procedure that results in the construction or reconstruction of the vagina. This is a type of genitoplasty. Pelvic organ prolapse is often treated with one or more surgeries to repair the vagina. Sometimes vaginoplasty is required after treatment or removal of malignant growth or abscess to restore normal vaginal structure and function. Surgery to the vagina is done to correct the congenital defects to the vagina, urethra and rectum. This will repair the bladder bulge into the vagina (cystocele) and rectocele (rectocele) into the vagina. Often, vaginoplasty is done to repair the vagina and structures attached by trauma or injury.
Congenital disorders such as adrenal hyperplasia can affect the structure and function of the vagina and sometimes the vagina is absent; these can be reconstructed or shaped, using vaginoplasty. Other candidates for surgery include babies born with microphouses, people with MÃÆ'¼llerian agenesis producing vaginal, transgender or transsexual hypoplasia, and women who have undergone vaginectomy after malignancy or trauma. Vaginoplasty can reduce the size of the vaginal entrance or alter the appearance of the vulva.
Video Vaginoplasty
Medical use
Vaginoplasty is a description of the following surgical interventions:
In some cases, extra tissue is needed to reconstruct or build the vagina. The grafts used in this vaginoplasty may be allogenic, heterograph, autograft, xenograft, or autologous material. A woman can use cultured in vitro autologous tissue taken from her vaginal vestibule as a transplanted tissue to form a reconstructed vaginal lining. The reconstructed or newly constructed vagina is called neovagina .
Vaginoplasties in children
Conditions such as congenital adrenal hyperplasia virilize genetic women due to 21-hydroxylase deficiency. Special procedures include: clitoral reduction, labiaplasty, normalized appearance, vaginal development, initiation of vaginal dilatation. Vaginal atresia, or the absence of a congenital vagina can be another reason for surgery to build a normal and functional vagina. Vaginoplasty is used as part of a series of surgeries necessary to care for girls and women born with a bladder located outside their abdomen. After the repair, women may give birth but are at risk of prolapse.
There are human rights concerns about vaginoplasty and other genital surgery in children who are not old enough to agree, including attention to postoperative sexual functioning, and heteronativity assumptions. There is no consensual attitude among clinicians about their needs, timing, methods or evaluation. Vaginoplasty can be performed in children or adolescents with intersex or developmental sex conditions.
Maps Vaginoplasty
Risks and complications
Reconstructive vaginoplasty in children and adolescents carries the risk of "superinfection".
In adults, the extent and type of complications vary with vaginoplasty of sex change. Necrosis in the clitoris area is 1-3%. Vaginal necrosis made surgically is 3.7-4.2%. Vaginal discharge occurs documented in 2-10% of those treated. Stricture, or narrowing of the vaginal opening is reported in 12-15% of cases. Of those who reported stricture, 41% underwent a second surgery to improve the condition. Necrosis of two scrotum scrotales has been described. Posterior vaginal wall is a rare complication. Genital pain is reported at 4-9%. Rectovaginal fistula is also rare with only 1% documented. Vaginal prolapse is seen in 1-2% of men assigned to men at birth undergoing this procedure.
Ability to empty the bladder was affected after this procedure with a 13% increase in reporting, 68% said that there was no change and 19% reported that the vacancy was deteriorating. They reported negative results experienced in which bladder control loss and urinary incontinence were 19%. Urinary tract infections occur in 32% of those treated.
Technique
Non-surgical vaginal production is used in the past to treat the absence of a congenital vagina. This procedure involves the use of devices such as saddles and the use of high-diameter dilators. This procedure takes several months and sometimes it hurts. It is not effective in every instance. Uncommon growth, cysts, septum in the vagina may also require vaginoplasty.
Reconstructive surgery after cancer treatment
Radiologic cancer treatment can cause damage or vaginal tissue changes. Vaginoplasty is often done to reconstruct the vagina and other genital structures. In some cases, normal sexual functioning can be restored.
McIndoe's surgical technique
The canal is a surgery built between the bladder and the urethra in the anterior part of the pelvic region and the rectum. Skin grafts are used from other areas of a person's body. Graft is removed from the thigh, buttocks, or inguinal area. Other materials have been used to create new vaginal lining. These are skin flap, amniotic membrane, and buccal mucosa.
Bowel vaginoplasty
Bowel vaginoplasty is a common method used to make artificial vaginas in male-to-female transgender surgery.
Genital replacement surgery
The operation of genital replacement to create the vagina consists of reversing the skin of the penis or increasing the depth, using segments of the colon or small intestine. In addition, a scrotum-penile skin flap is also used. Nongenital full-thickness graft (FTG) or split-thickness skin graft from other parts of the body have been used. The reversal of the penis skin is the method most often chosen by surgeons who perform sex change operations. The inverted penis skin uses inferior pedicle skin or abdominal skin for the lining of the vagina that is made. The skin is cut to form a suitable sized flap. Skin flaps are sometimes combined with a scrotum or urethral flap. Sex change therapy is often part of the treatment plan.
Elective vaginoplasty
Critics have labeled operations like "designer's vagina". The American College of Obstetricians and Gynecologists issued a warning against this procedure in 2007 as did the Royal Australian College of Gynecologists, and comments in the British Medical Journal strongly criticized the "vaginal designer" in 2009. The Society of Obstetricians and Gynecologists of Canada publishes a policy statement on elective vaginoplasty based on the risks associated with unnecessary cosmetic surgery by 2013.
The World Health Organization describes unnecessary medical surgery of vaginal tissue and organs as female genital mutilation.
Vaginal rejuvenation is a form of elective plastic surgery. The goal is to restore or improve the appearance of vaginal cosmetics.
Labiaplasty
Labiaplasty can be performed as a discrete surgery, or as a subordinate procedure in vaginoplasty. Several surgeries may be necessary for the discomfort caused by chronic labial irritation that develops from tight clothing, sex, exercise, or other physical activity.
Hymen's surgical procedure
The imperforate hymen is a tissue that completely covers the vaginal opening. Cut to allow menstrual flow out during short surgical procedures. Hymenorrhaphy is a surgical procedure that reconstructs the hymen.
Balloon vaginoplasty
In this procedure, a laparoscopic foley catheter is inserted into a rectouterine bag where incremental traction and distension are applied to create neovagina.
Procedure Pull through or Vecchietti
In treating agenesis mÃÆ'¼llerian, the Vecchietti procedure is a laparoscopic surgical technique that produces a vaginal dimension (depth and width) comparable to normal vagina (about 8.0 cm). Small plastic ball ("olive") threaded (sewn) in the vaginal area; the yarn is drawn though the skin of the vagina, up through the stomach, and through the navel. There, the yarn is attached to the traction device, and then every day drawn tight so that the "olive" is pulled in and stretch the vagina, about 1.0 cm. per day, thus creating the vagina, about 7.0 cm. depth of 7.0 cm. wide, in 7 days. The average operating room (OR) for Vecchietti vaginoplasty is about 45 minutes; however, depending on the patient and its indications, the procedure may require more time. The results of the Vecchietti technique through a laparoscopic approach were found to be comparable with the procedure of using laparotomy. In vaginal hypoplasia, traction vaginoplasty like the Vecchietti technique appears to have the highest anatomical (99%) and functional (96%) success rates among available treatments.
Other surgical techniques that have been developed include ileal neovagina (Monti technique), Creatsas vaginoplasty, Wharton-Sheares -George neovaginoplasty, or the Davydov procedure. The most widely used is the laparoscopic procedure of Vecchietti. Sometimes sexual intercourse can result in a newly built vaginal dialysis.
See also
- Intersex medical intervention
- Genital (male-to-female) surgery
- List of transgender related topics
- Enterokel
- Sigmoidocele
References
Bibliography
- Baggish, Michael (2016). pelvic anatomy atria and gynecological surgery . Philadelphia, PA: Elsevier. ISBN: 9780323225526.
- Emans, Herriot (2011). Eman, Laufer, pediatric Goldstein & amp; teenage gynecology . Philadelphia: Wolters Kluwer Health/Lippincott Williams & amp; Wilkins Health. ISBN: 9781608316489. Ã, electronic book, no page number.
Source of the article : Wikipedia
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