Hymenotomy, simple incision
CPT4 code
Name of the Procedure:
Hymenotomy, Simple Incision
Common Name: Hymenectomy
Summary
A hymenotomy is a minor surgical procedure that involves making a simple incision in the hymen. This is often done to alleviate symptoms associated with an imperforate or septate hymen.
Purpose
The purpose of a hymenotomy is to address conditions where the hymen partially or completely covers the vaginal opening, causing menstrual flow obstruction, pain, and other symptoms. The goal is to create an opening in the hymen to allow for normal menstrual flow and alleviate associated discomfort.
Indications
- Imperforate hymen causing menstrual flow obstruction
- Septate hymen leading to pain or difficulties with tampon use or intercourse
- Symptoms such as severe menstrual pain, abdominal pain, or difficulty with tampon insertion/removal
Preparation
- Patients may be advised to fast for a specified period before the procedure if general anesthesia will be used.
- Pre-procedure consultation to discuss medical history, allergies, and medications.
- A pelvic examination and possibly an ultrasound to assess the anatomical structure.
Procedure Description
- The patient is positioned appropriately on an examination table.
- Local anesthesia or sedation is administered to ensure comfort.
- The hymen is carefully examined.
- A small incision is made to open the hymen partially or completely.
- Any excess tissue may be removed to ensure a sufficient opening.
- In cases where general anesthesia is used, the patient is awakened in a recovery area post-procedure.
Tools and Equipment:
- Scalpel or surgical scissors
- Local anesthetic agents
- Sterile drapes and gloves
Anesthesia:
- Local anesthesia or mild sedation is typically used. General anesthesia may be used in some cases.
Duration
The procedure usually takes about 15 to 30 minutes.
Setting
Hymenotomy is often performed in an outpatient clinic, a surgical center, or a hospital.
Personnel
- Gynecologist or surgeon
- Anesthesiologist or nurse anesthetist (if anesthesia is used)
- Nurses and surgical assistants
Risks and Complications
- Infection at the site of the incision
- Excessive bleeding
- Scarring or adhesion formation
- Pain or discomfort post-procedure
- Very rarely, anesthesia-related complications if general anesthesia is used
Benefits
- Relief from menstrual flow obstruction
- Alleviation of pain and discomfort
- Improved ability to use tampons or engage in intercourse
- Benefits are generally realized almost immediately following recovery
Recovery
- Patients may experience mild pain or discomfort, manageable with over-the-counter pain relievers.
- It’s advisable to avoid strenuous activities and sexual intercourse for a few weeks.
- Follow-up appointments are usually scheduled to ensure proper healing.
- Hygiene instructions to prevent infection.
Alternatives
- Using hormonal treatments or medications to manage symptoms, though these do not address the physical blockage.
- Non-surgical methods to stretch the hymen, which can be less effective and more uncomfortable than surgery.
Patient Experience
During the procedure, with local anesthesia or sedation, the patient should feel minimal discomfort. Post-procedure, there may be mild pain or tenderness for a few days. Pain management includes OTC pain relievers, and comfort measures such as avoiding tight clothing and following post-operative care instructions.
Please consult with your healthcare provider for detailed consultation and any specific queries.