Partial hymenectomy or revision of hymenal ring
CPT4 code
Name of the Procedure:
Partial Hymenectomy or Revision of Hymenal Ring
Summary
A partial hymenectomy or revision of the hymenal ring is a minor surgical procedure to remove a portion of the hymen (a thin membrane surrounding the vaginal opening) or to correct abnormalities or issues with the hymenal tissue.
Purpose
This procedure addresses issues such as hymenal stenosis (a condition where the hymen is too thick or not flexible, causing pain or difficulty during menstruation, tampon use, or sexual activity). The goal is to alleviate discomfort, improve function, and enhance the patient's quality of life.
Indications
- Pain, discomfort, or difficulty during menstruation, tampon use, or sexual activity
- Hymenal abnormalities detected during a pelvic exam
- Psychological or physical distress related to hymenal tissue
- Preparation for certain gynecological procedures
Preparation
- Follow fasting guidelines if anesthesia is required (usually no food or drink 6-8 hours before the procedure)
- Avoid certain medications such as blood thinners as instructed by the doctor
- Undergo a pelvic exam and possibly an ultrasound to assess the hymenal tissue
Procedure Description
- The patient will be positioned comfortably, often in a lithotomy position.
- Local anesthesia, sedation, or general anesthesia may be administered depending on the patient's needs and preferences.
- The surgeon will carefully incise and remove a specific portion of the hymenal tissue.
- Absorbable sutures may be used to close any incisions, ensuring minimal scarring.
- The procedure is typically quick, with minimal blood loss.
Duration
The procedure usually takes about 15-30 minutes.
Setting
- Outpatient clinic
- Surgical center
- Hospital, if other medical issues need addressing simultaneously
Personnel
- Gynecologist or specialized surgeon
- Nursing staff
- Anesthesiologist (if sedation or general anesthesia is used)
Risks and Complications
- Infection
- Bleeding
- Pain or discomfort post-procedure
- Scarring
- Rare risk of reaction to anesthesia
Benefits
- Relief from pain and discomfort
- Improved ability to use tampons or menstrual cups
- Enhanced sexual comfort
- Overall improved quality of life
Recovery
- Mild discomfort and spotting are normal post-procedure.
- Pain management with over-the-counter pain relievers or prescribed medication.
- Avoid strenuous activities and sexual activity for a few weeks.
- Follow-up appointment to ensure proper healing.
- Good hygiene practices to prevent infection.
Alternatives
- Careful and gradual use of dilators to gradually stretch hymenal tissue (less invasive, but can take time and may not be effective for all patients)
- Observation and reassurance (if symptoms are mild or intermittent)
Patient Experience
During the procedure, patients may feel some pressure or discomfort, especially with local anesthesia. Post-procedure, mild pain and swelling are common and manageable with pain relief medication. Most patients will notice improvements within a few weeks and can return to normal activities fairly quickly, with follow-up care to ensure proper healing.