Vaginoplasty in Sharjah

What is vaginoplasty?

Vaginoplasty, in women's gynaecology, is a surgical tightening of the vaginal canal. The vagina is a muscular tube, and its walls are supported by the levator ani muscles of the pelvic floor, which run like a sling on either side. Pregnancy, vaginal birth and the hormonal changes of menopause can stretch these muscles and the lining over them, so the canal becomes wider than it was.

The operation works mainly on the back (posterior) wall of the vagina. The gynaecologist brings the separated muscle edges closer together in the midline, trims a strip of loose lining, and closes it again, which narrows the canal along its length. Because the whole procedure is done through the vaginal opening, the scar sits on the inside.

Vaginoplasty is different from device-based vaginal tightening. Radiofrequency and laser treatments heat the vaginal lining in a clinic setting, without cutting, and act on the surface tissue. Surgery reshapes the muscle layer itself, so it is the option discussed when the muscles have separated. At Dar Al Kamal Hospital, Sharjah, vaginoplasty is performed in-house by the gynaecology and obstetrics team.

Who needs it

Vaginoplasty is considered for women who have a sensation of vaginal looseness or laxity that bothers them, most often after one or more vaginal births. Some women also describe tampons slipping, a feeling of heaviness, or air passing from the vagina during exercise. A bulge of the back wall into the canal (a rectocele) is sometimes found at the same time, and repairing it is part of the same operation.

The decision starts with an examination to see which parts of the canal and pelvic floor are involved. The main options are:

• pelvic floor therapy, a structured programme to strengthen the muscles that surround the canal, often the first step
• device-based treatment with radiofrequency or laser energy, which acts on the lining
• vaginoplasty, which rejoins and tightens the muscle layer

Where the entrance and perineum are also stretched or scarred, the operation can be combined with perineoplasty. If leaking urine is part of the picture, the urinary incontinence team assesses it as well, since bladder symptoms have their own treatments. Your gynaecologist explains how the options compare for you, and the choice is yours.

What happens

Vaginoplasty takes place in an operating theatre under general anaesthesia or a spinal anaesthetic, agreed with the anaesthetist beforehand. You lie on your back with your legs supported in stirrups.

The gynaecologist opens the lining of the back wall along the midline, separates it from the muscle beneath, and places a series of stitches that draw the muscles on each side towards the centre. The amount of tightening is judged during the operation against the width agreed with you at consultation. Excess lining is trimmed and the wall is closed with dissolving stitches.

A soft vaginal pack and a urinary catheter are sometimes placed at the end and removed before you go home. Vaginoplasty often involves a short hospital stay, and you leave once you are passing urine, walking comfortably and your pain is controlled with tablets.

Preparing for it

Your consultation includes an internal examination, and a cervical screening test is brought up to date if one is due. Any vaginal or urinary infection is treated first. A pre-operative assessment, blood tests and an anaesthetic review follow. Tell the team about every medicine you take, including blood thinners, hormone treatment and diabetes medicines, and you receive fasting instructions for the day.

Plan the date between periods where possible, and stop smoking to help healing. Have sanitary pads, loose cotton underwear and easy meals ready at home, and arrange help with lifting and children for the first weeks. If you would like surgery around Ramadan, raise it early so fasting and fluids can be planned around your recovery.

Afterwards

Some soreness, swelling and a light blood-stained or yellowish discharge are normal while the internal stitches dissolve. Showering is fine; rinse the outside with plain water and pat dry. Short walks at home help circulation and bowel function, and a diet rich in water, fibre, fruit and vegetables keeps stools soft, which protects the repair of the back wall.

Avoid heavy lifting, straining and high-impact exercise while you heal. In the Sharjah heat, drink plenty of water and wear breathable clothing. The gynaecologist reviews you at a follow-up appointment and tells you when intercourse, tampons, swimming and your normal exercise can resume; the timing for returning to work depends on whether your job is desk-based, involves driving, or is physical.

Contact the hospital urgently if you develop a fever, a foul-smelling discharge, increasing pain or difficulty passing urine or opening your bowels. **Go to the emergency department straight away if you have heavy vaginal bleeding or pain and swelling in one calf, or sudden breathlessness.**

Cost and insurance

Vaginoplasty performed for vaginal laxity alone is usually treated as a cosmetic procedure and is self-pay. When the operation repairs a prolapse of the back wall that causes symptoms, insurance may cover that part with pre-approval, based on the gynaecologist's examination. Dar Al Kamal Hospital, Sharjah can help you check your cover and request approval on 06 599 7777.