Name of the Procedure:

Plastic Repair of Introitus
Common name: Perineoplasty
Medical term: Introital Repair

Summary

In layman's terms, plastic repair of the introitus is a surgical procedure to restore or enhance the opening of the vagina (introitus) that may have been damaged or altered due to childbirth, trauma, aging, or surgery.

Purpose

This procedure is designed to address issues such as vaginal laxity, tears, or discomfort, aiming to improve vaginal function and appearance and to alleviate symptoms like pain or incontinence.

Indications

• Vaginal laxity or looseness
• Perineal tears or damage from childbirth
• Discomfort or pain during intercourse
• Urinary incontinence
• Cosmetic concerns
• Prolapse of pelvic organs

Preparation

• Fasting may be required for a certain period before the procedure.
• Patients might need to adjust or stop certain medications.
• Diagnostic tests like pelvic exams, PAP smears, or imaging studies might be necessary.

Procedure Description

1. Anesthesia: General or local anesthesia with sedation is administered.
2. Incision: A precise incision is made at the vaginal opening.
3. Tissue Repair: Damaged tissues are repaired or removed, and muscles may be tightened.
4. Closure: The incision is closed with sutures.
   • Tools & Equipment: Scalpel, sutures, retractors, and surgical scissors.
   • Anesthesia: General or local anesthesia is used to ensure patient comfort.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

Plastic repair of the introitus is usually performed in a hospital or an outpatient surgical center.

Personnel

• Surgeon (a specialist in gynecology or plastic surgery)
• Anesthesiologist
• Surgical nurses
• Operating room staff

Risks and Complications

• Common risks: Infection, bleeding, bruising, and swelling.
• Rare risks: Scarring, nerve damage, chronic pain, unsatisfactory results, or reactions to anesthesia.
• Management: Post-operative care and medications to manage complications.

Benefits

• Improved vaginal tightness and function
• Enhanced sexual satisfaction
• Alleviation of pain or discomfort
• Improved self-esteem and body image
• Benefits might be realized within a few weeks post-procedure.

Recovery

• Follow post-procedure care instructions: keeping the area clean, managing pain with prescribed medications, and avoiding strenuous activity.
• Expect some swelling and discomfort for a few days.
• Full recovery usually takes 4-6 weeks.
• Follow-up appointments will be necessary to monitor healing.

Alternatives

• Kegel exercises
  • Pros: Non-invasive, no recovery time.
  • Cons: May not be effective for significant damage.
• Pelvic floor physical therapy
  • Pros: Non-surgical treatment option.
  • Cons: Requires a long-term commitment and may not address all issues.
• Laser therapy
  • Pros: Minimally invasive.
  • Cons: Multiple sessions might be required.

Patient Experience

• During: Patients will either be asleep (general anesthesia) or comfortable with sedation and local anesthesia.
• After: Expect mild to moderate pain, managed with medications. Swelling and bruising are common, and care should be taken with hygiene and physical activity.
• Pain management includes prescribed pain relievers and comfort measures such as ice packs or sitz baths.