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Vagina reconstruction or vaginoplasty after childbirth may be required in some women for various reasons, including sexual dysfunction. This can be related to women’s physical and psycho-emotional states, as well as their experiences. If necessary, vajinoplasti in postpartum women can be performed during a cesarean delivery or within 6 weeks after normal vaginal delivery. Performing an incision in the hymen, in postpartum vaginoplasty after childbirth, special reconstruction techniques allow restructuring as it is located at the midlevel of the vaginal introitus to provide vaginal narrowing and increased sexual satisfaction. The aim of this chapter is to describe the surgical techniques and postpartum vaginoplasty benefits in women.
The vagina changes superficially after childbirth, which is why increasing numbers of women demand surgical treatment. There is simply no data regarding human vaginal pressure over time corresponding to deliveries by orifice animals. The effect of restoring vaginal function after childbirth is more significant in 30-50% of multiestrous. The passage through the birth canal usually smooths itself in the correct orthogonal axis, but many lateral vaginal walls are visible. After a tiring vaginal childbirth, the vaginal wall will have a marked glycos role that will be outlined. Large suction cups are useful enough to contain the seal, but not forces. With the hand on the fetal head, muscles in the extremities of the introitus are torn.
Vaginoplasty is known as one of the changes observed after vaginal delivery. Vaginoplasty surgery includes reconstruction and reduction of the lateral vaginal canal walls to tighten the vaginal walls and the perineal body. Vaginoplasty techniques use a technique to change the lateral pressure, strength or volume to adjust the ventral-ventral position, which is the first step in that LAMM is based on the LFS and apply a full-thickness incision involving the vagina and perineum. Thus, this technique first forms the posterior wall of the vagina into a vertical manner. Nowadays, many advanced tools and techniques are available to overcome breast and facial volume, body girth and instead to be increased by applying volume fillers and prostheses. Although it can be fixed after the initial durable effect and surgical removal, it lacks long-term effectiveness and creates biological damage to the use of foreign bodies.
Vaginoplasty is mainly indicated for patients with postpartum vaginal surgery seeking to reconstruct the vaginal opening and tighten the vaginal canal, also known as a “Mommy Makeover”. The laxity and morphological changes in the vaginal tissue caused by restoring vaginal function after childbirth alter the tactile function, leading to anorgasmia, increased diameter of intra-canal proximal and middle vaginal originating from the lateral planes, uterine cervix protrusion in the vaginal lumen and loss of sensation on the lateral-vertical portion of the vaginal. Vaginal birth can result in loss of vaginal tissue and perineal muscles that support the paravaginal ligaments. It is possible through the rectovesical leap-vaginal muscles- obturator septum, which is responsible for the urethra extension for neuro-pudendal events and inspired the autonomic nervous system. Therefore, if the diagnosis is supported by the digitorectal exam to confirm hypotonia muscle as well as any androgenization of the patient, the withdrawal therapy of nandrolone may be combined with the reconstruction of the remaining bulbar muscles, the six dorsal muscles, and internal body gluteus muscles to increase spa amenity.
Postoperative care and recovery are extremely important segments of the vaginoplasty for new mother’s process; they dictate the manner in which women are going to heal from their surgery. Women have to take good care of themselves in the postoperative period, in order to lessen the risks of complications and to get the best possible results. Patients will feel some post-surgical discomfort when the anesthesia wears off. During this time, mothers may get some postsurgical medicinal therapy. The women are also educated to keep the procedure site very hygienic, which involves regular wound site cleaning, eosin-free gauze dressing, and regular use of water-containing bidet. They are also educated to be cautious with regard to their movement so that they can prevent accidental traumatic harms of their association site.
In conclusion, vaginoplasty after childbirth improves the functional and aesthetic nature of the scar that a patient gets after episiotomy or spontaneous wedge resection. A patient can return to her daily life with an activated sexual lifestyle after recovery from vaginoplasty for new mothers. The earliest possible is better. Mothers can return to work and take some medications to recover better. In the early postoperative period, alternating hot and cold treatments are required, mostly on the first day after the procedure and for 2 more days. Women are requested to abstain from heavy exercise for 2 weeks and to resume sexual associations 6 to 8 weeks after the procedure. Also, patients require to be gentle with anything and do not stay faithful during these periods. Mothers with high discomfort are instructed to stop the approach.
Therefore, they should be suggested to make regular vaginal dilators of increasing thickness. Any stress, distress, and other mood changes can be evaluated and treated accordingly.
Birçok farklı teknik var vajinal gençleştirme ameliyatı, ancak doktorlar her zaman vulvanın inşasıyla başlayacaktır. Ameliyat genellikle bir hastane ameliyathanesinde genel anestezi altında yapılır. Ameliyat penisin çıkarılmasıyla başlar. Skrotumlar bazen dış dudakları oluşturmak için kullanılır. Testisler skrotumdan çıkarılır ve skrotum derisi vajinanın dış dudaklarını oluşturmak için çevrilir. Penis derisi cerrahi olarak soyulur ve vajinal bir kanal oluşturmak için kullanılır. Cerrahlar genellikle iç dudakları oluşturmak için bir deri flebi ile kaplı olan vajinal kanalı kaplamak için kolonun uzunluğunu kullanırlar. Yeterli penis deriniz varsa, cerrahlar vajinal kanalı kaplamak için onu ters çevirebilir ve bağırsak astarlarından herhangi birini skrotum derisi ile değiştirebilirler. Buna 'bağırsak veya tam astar' denir.
Ameliyattan önce, gelecekte genetik olarak ilişkili çocuk sahibi olmak istemeniz durumunda kendi vücut sıvınızdan (kan veya ejakülat) bir miktar toplanacak ve dondurulacaktır. Bacaklarınızın arasında temizlenmesi gereken bir yaranız olacak. Ameliyatınızdan sonra bir hafta boyunca bir katetere ihtiyacınız olabilir.. Vajinanın içindeki dikişler 4 ay sonra erir. Cildi kapatmak için kullanılan dikişler genellikle 2 hafta sonra erir. Eriyen dikişler, onları aldırmanıza gerek kalmaz. Ameliyatın sonunda neovaginaya herhangi bir tampon veya stent yerleştirilmez. Çalışmalar, iyileşirken vajinada herhangi bir şey olmasının bir faydası olmadığını göstermektedir.
İyileşme ve ayakta tedavi Tam zamanlı bir işiniz varsa, cerrahlar genellikle 6-8 hafta veya iş fizikselse daha uzun süre izin almanızı önerir. Ameliyatınızdan hemen sonra hafif aktivitelere geri dönmeniz mümkündür. Düzenli cinsel aktiviteye genellikle 3 ay sonra dönülebilir. Cerrahi tekniklerindeki gelişmeler vajinoplasti prosedürleri saçsız yüksek kaliteli neovajinal doku evrimine yol açmıştır. Ne yazık ki, saç taşıyan deri üretroplastisinden sonra bile üretra stentleri gereklidir. Sekmesi çıkarılmış veya epitelsizleştirilmiş serbest flepler gibi sentetik seçenekler araştırılmıştır, ancak bu tekniklerin hiçbiri saç kaybı riskini tamamen ortadan kaldırmaz.
Although vajinoplasti in natal women with vaginal agenesis has undergone evaluation and assessment, no reports of successful RCT vaginoplasty in postpartum women have ever been attempted. There are emerging and promising technologies that are currently being investigated in animal models and preclinical studies, such as Magnetic Anastomosis, Fecal Microbiota Transplantation, and Fibrin Sealant. These technologies have the potential to be aggressive and safe and may have implications to reduce the risk of vaginoplasty for new mothers dehiscence, protect spontaneous healing and avoid sutures, reduce hematoma and seroma formation with fewer quantity and duration of postoperative infection and inflammation, simplify the surgical procedure by reducing the overall surgery time and recovery. In addition, reducing specified and non-specific inflammation and sex steroids, fibroblast activity, modulating extracellular matrix deposition and organization, reducing apoptosis of vaginal and perineal tissues, and regulating the immune system could be an attractive approach to assist in the primary outcome indicating that early wound healing has been improved in postpartum vaginal surgery. We anticipate human trial(s) to be evaluated and implemented within the next 5-10 years. However, further animal studies and preclinical trials will need to be conducted.
The goal of this process is to further reduce the dehiscence incidence from one in seventeen patients to further reduce the length of the longitudinal epithelial scar. The initial outcome would not only significantly promote the wound healing process (12-15 days), reduce the submucosal tear and fall in the extracellular matrix, use of wound adhesives to reduce subcutaneous tension, but also increase sexual manageability after surgery. Thus, where these initial studies will add to the enhancement of the patient, the ongoing studies will add to the reduction in maternal adverse outcomes.
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