Plastic surgical postero-lateral redirection extension vulvo-vaginoplasty

Area of Science:

• Gynecologic Surgery
• Female Sexual Dysfunction
• Reconstructive Urology

Background:

• Recurrent cystitis and deep dyspareunia often stem from coital trauma to the bladder and internal genitalia.
• Vaginal axis misalignment can contribute to pain and reduced sexual satisfaction.
• Existing treatments may not adequately address complex cases of coital pain and dysfunction.

Purpose of the Study:

• To report on a novel vulvo-vaginoplasty technique for treating refractory coital cystitis and dyspareunia.
• To improve sexual function by altering vaginal axis and enhancing clitoral stimulation.
• To expand surgical indications for vaginal reconstruction.

Main Methods:

• A vulvo-vaginoplasty procedure was performed to rotate the vaginal axis.
• Standard reconstructive surgical techniques were employed.
• Vaginal extension and a new introitus were constructed from the labia majora.
• The clitoris was circumcised to enhance response.

Main Results:

• The modified vaginal axis reduced coital trauma to the bladder and internal genitalia.
• Alignment with the clitoris and labia improved mechanical efficiency of clitoral manipulation.
• Circumcision of the clitoris augmented clitoral response intensity.
• Preliminary results indicate positive outcomes in patient cohorts.

Conclusions:

• This vulvo-vaginoplasty offers a viable surgical option for managing coital cystitis and deep dyspareunia.
• The procedure enhances sexual response by optimizing anatomical relationships and clitoral stimulation.
• The technique is also applicable for treating vaginal strictures and shortening.