Hymenoplasty is a surgical procedure that involves restoring to normal a torn hymen for cultural, religious or social reasons.
The hymen is a ring-like skin membrane that sits in the lower 1/3 of the vagina. It marks the spot that the vulvovaginal bulbs fuse with the Mullerian ducts from above then hollow out to form the vagina. Most often there is a 5 or 6 pointed star opening in the hymen after maturity. With first intercourse or by accident from falling or tampons, 2 or 3 areas tear in the hymen. Most often there is bleeding at the time of tearing.
The hymenoplasty procedure (to reconstruction the hymen), is after using local anesthetic
for tissue dissection and to stop small blood vessels from bleeding, the areas which were torn are “denuded” meaning the upper layer of tissue is removed. This is so that they will grow back together when they are approximated with stitches. Then after they are denuded, the edges are brought back together to reform the star-shaped “ring” as it was prior to relations, accident etc. It is made small enough, so that when first sexual relations occur later on, it will “tear” again, there will be some pain, and there will be bleeding.
Most surgeons only perform hymenoplasty or hymen repair (hymen restoration surgery) at the request of someone who needs the surgery for ethnic, cultural, or religious reasons. Also, most surgeons will not perform hymenoplasty surgery in a woman who has given birth.
Hymenoplasty generally takes about one to two hours, with patients able to return to work the next day. Restoration of the hymen is done on an outpatient basis, under local anaesthesia or sedation. Prior to surgery, patients are required to have a pre-surgical consultation and thorough gynecological examination.
Who is eligible candidate for the treatment?
The suitable candidates are –
- Those who have ruptured their hymen due to sex or other activities
- Those who are above 18 years of age
- Women who are healthy and don’t suffer from any serious illnesses
A gynecological exam is also necessary to determine if your hymen can be restored or not.
Who is not eligible for the treatment?
In case the woman is suffering from cancer of the genital or venereal diseases, only then she is not eligible for the treatment.
Timing of Hymenoplasty.
The timing of anticipated coitus may play a role in selecting a surgical approach. For patients who desire structural integrity and need the hymen to be intact on visual inspection, the repair should be performed 3 months before the “consummation of marital vows.” However, when the timing of coitus is known, and the patient desires bleeding but visual integrity is not needed. Surgery is often best scheduled 3 weeks before the date.
Surgical Procedure:The choice of procedure is decided by the surgeon based on desired outcome and time till marriage. The most common procedures are flap technique, surgical adhesion, luminal reduction and suture only techniques. It is performed as a day care procedure under local anesthesia with sedation or preferably under general anesthesia due to the anxiety of the procedure involved. All techniques achieve the same goal of forming adhesions between hymen remnants and narrowing the introitus.
What is the Recovery After Hymenoplasty?
Mild discomfort is treated with oral pain medication for a few days. Wound care consists of gentle irrigation after urination and patting after defecation. You can take shower the next day, and should not use public pools, hottubs, and saunas for 4 weeks. If you start your menstrual cycle, it is recommended you avoid using tampons for your next 1–2 cycles to avoid irritation of the incisions while they are healing. At least couple of days should be taken off work or arrange to work from home during this time. Aggressive physical activity should be avoided for at least a week or two after surgery. Sexual intercourse should be avoided for approximately 4 weeks after a hymenoplasty. By week 6 to 8, the healing is complete, and no restrictions are needed.
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Risks and complications.
Hymenoplasty is a safe procedure and other than the usual anaesthesia risks no major complications exist. Because of the use of small dissolving suture there may be mild bleeding from the surgical wound, possibly caused by walking or other activities. Failure to bleed on intercourse and repair breakdown are the only surgical complications. Do I need accompanying person? If you are major (> 18 years) there is no need of accompanying person. The secrecy and confidentiality is strictly maintained.
There are no signs visible after surgery. Initial few weeks till the sutures get absorbed there will be sutures seen on visual inspection. Once you have recovered full, you will see an intact hymen likenatural one without any scar mark. Can it be combinedwith other procedures? Hymenoplasty can be combined with labioplasty for vulvalshaping or vaginoplasty when there is vaginal laxity.