Vaginoplasty

Vaginoplasty aims at restoring the laxity of the vagina that becomes loose due to vaginal delivery, natural aging, multiple pregnancies, accidental trauma, etc.

Types:
Depending on the age of the patient, the body part used for constructing the vagina, and the purpose for undergoing vaginoplasty, the different types of vaginoplasty procedures include:

1. Intestinal or sigmoid vaginoplasty: This procedure involves using a part of the sigmoid colon (a part of the large intestine) to create a new vagina. 
2. Peritoneal vaginoplasty or Luohu operation: In this procedure, the peritoneum (abdominal cavity lining) is used to create the vagina.
3. McIndoe vaginoplasty: This procedure involves lining the vagina using a skin graft.
4. Buccal mucosa vaginoplasty: The buccal mucosa tissue (tissue lining the mouth) is harvested to the vagina in this type of procedure.
5. Penile inversion vaginoplasty: In the case of transgender women, the skin from the outer portion of the penis will be removed and inverted to create the lining of the vagina.

Symptoms

Purpose:
Vaginoplasty is recommended in the following cases:

1. Repair of trauma to the vagina
2. Repair of childbirth (congenital) defects that affect the vaginal development 
3. For improving sexual function
4. Vaginal reconstruction after radiation therapy (a type of cancer treatment) or surgical excision of the vagina
5. Transgender people who undergo gender affirmation (change of gender) surgery

Diagnosis

1. Physical examination: The patient’s overall physical health will be evaluated by the doctor. The symptoms, medical history, and sexual history of the patient are noted.
2. Pelvic exam: One or two gloved, lubricated fingers are inserted into the vagina to feel the size, shape, and position of the uterus and ovaries. The other internal female reproductive organs are also checked using this procedure.
3. Blood tests: These tests help in evaluating the body's hormone levels, the different parameters of blood, and the presence of any underlying medical conditions.
4. Ultrasound: Sound waves are used to create pictures of the internal organs of the female reproductive organs of the body. 
5. Magnetic resonance imaging (MRI): This procedure involves the use of magnetic waves to create detailed images of the female reproductive organs and the kidneys.

Treatment

1. This procedure is performed under general anesthesia (the patient will be put to sleep during the procedure) or local anesthesia (the treatment area is numbed) with sedation.
2. The patient will first lie down on the operation table with the legs spread wide apart.
3. A pie-shaped wedge is created by the surgeon to remove the excess skin present at the vaginal opening.
4. The vaginal mucosa will then be separated from the vaginal muscles.
5. The vaginal canal muscles will then be tightened, along with the muscles at the vaginal opening.
6. The surgeon may sometimes perform the procedure laparoscopically, which is a minimally-invasive procedure and involves making small key-hole incisions at the vaginal area to insert a laparoscope (tube with a camera on one end) and other small surgical instruments to carry out the procedure of vaginoplasty.
7. The incisions are then closed using external and internal dissolvable sutures (stitches).
8. Depending on the type of vaginoplasty being performed, a vagina dilator (a tube-shaped device used to stretch the vagina) may be given to the patient.
9. The procedure may take about one or two hours to complete.

Risks

The complications associated with vaginoplasty are:

• Inflammation
• Pain 
• Bleeding
• Infection
• Vaginal prolapse (when the vagina drops from its normal position in the body)
• Scars formation 
• Blood clot formation 
• Disorders of the vagina and uterus
• Formation of vaginal fistula (an abnormal opening that connects the vagina to the other organs)
• Urinary retention
• Rupture of the sutures 
• Skin necrosis (an injury leading to the death of the tissue)
• Necrosis of the clitoris, which is present at the top of the vagina

After Procedure

• You will usually be discharged on the same day of the procedure.
• It is normal to have mild pain and swelling after a vaginoplasty.
• You may have mild vaginal bleeding and discharge for approximately four to eight weeks after the surgery.
• A vaginal dilator is provided by the surgeon and should be used after the bandages are removed. It should be used daily for at least one year after surgery to maintain the desired vaginal depth and girth.
• You can resume work after one week of surgery.

Home remedies:

1. You will be given pain-relieving medications after surgery to relieve your discomfort.
2. Ice packs should be applied on the site of surgery for approximately 20 minutes every hour, for one week following the surgery.
3. You cannot have sexual intercourse for at least three months after the surgery.
4. You should avoid swimming and hot water bath for at least eight weeks following the surgery.
5. Avoid heavy lifting and strenuous exercises for at least six weeks following the surgery.
6. Do not insert anything into the vagina, including tampons, during the recovery period.
7. Do not smoke for at least one month after surgery.
8. You will be told not to ride a cycle or motorcycle for at least three months after surgery.

Cost of Vaginoplasty in India- 

The cost of vaginoplasty in Mumbai is between INR 60,000 to INR 1,00,000.
The cost of vaginoplasty in Delhi is between INR 50,000 to INR 80,000.
The cost of vaginoplasty in Bangalore is between INR 50,000 to INR 80,000.
The cost of vaginoplasty in Chennai is between INR 40,000 to INR 70,000.