These surgeries which are becoming more and more common and popular worldwide recently can be conducted on any woman who is not happy with the way their genital area look. Part of sexual problems/complications of women are psychological while sexuality is also affected by functional and aesthetical concerns.
• Vaginoplasty (vaginal contraction)
• Labioplasty (labia minora aesthetics)
• Labia majora filling (labia majora aesthetic/filling)
• Genital bleaching (laser genital bleaching)
• Laser vaginal rejuvenation
• Laser urinary incontinence treatment
• G-point shot
• Clitoris Aesthetics (clitoral hudoplasty)
• Cystocele and Rectocele Repairment
Vagina is an internal channel that is approximately 8-9 cm long, is the female area where the coitus occurs, that can stretch and is made of muscle tissue. The muscles surrounding the vagina loosen due to factors as age, congenital loose vaginal tissue, deliveries, gynaecological operations and frequent sexual coitus, and it might become less tight in time. The vagina can be structurally wider than usual in some female individuals despite any deliveries and young age. A wide vagina can’t wholly surround and feel the penis. The feeling of pressure on the penis of sexual partner becomes less. This might lead to problems such as not being able to have orgasm called anorgasmia in the later stages.
Therefore, the pleasure of the male and female partner during the coitus becomes less as well. This might cause serious problems between the partners (sexual partners) by getting a bigger one in time. Quite pleasant results can be obtained as a result of surgical vagina contraction, or in other words, the vaginoplasty operation. The surgery takes around 30-40 minutes. It can be applied through general, spinal or locally supported sedation. Wide parts of the vagina are removed, the muscular tissue underneath is repaired and the edges that are cut are repaired aesthetically. One month of sexual abstinence is prescribed after the surgery.
Labia minoras are gyrose and elastic structures which start in between bigger lips from the level of clitoris (sexual pleasure area) above the vagina and end below the vagina it. Its size varies from person to person. In some female individuals, it’s bigger than usual due to hormonal changes during puberty and effuses. They might grow in ptotic, symmetrical or asymmetrical ways. The reason of this growth is usually structural and it might also occur in later stages. These labia minoras that grew might block the vagina and the urinary canal called urethra.
They might cause infections both in vagina and in urinary canal by creating a moist area. Additionally, problems such as funny smell, hygienic problems due to sweating of labia minoras and problems such as dryness, scratchiness and wounds due to contact with underwear might occur.
Bigger labia minoras might make the entrance of the penis into vagina more difficult during coitus. When all these problems of a female individual not finding her genital area aesthetical, having hygienic and sexual problems considered, sexual problems (sexual disorders) such as less confidence and lack of sexual drive, not being able to have orgasm and difficulty in having orgasm might occur. These problems could also affect the sexual partner in the later stages. This condition can be fixed through a simple surgical procedure. Labia minoras which have grown, ptotic, long, asymmetrical, dark colored would be fixed to their usual appearance. This surgical reparation operation is called labioplasty. This operation which takes around half an hour could be applied combined with other genital aesthetical procedures. All the ripples and skin folds that don’t seem nice should also be fixed considering the genital area as a whole during the operation. If only the labioplasty is in question, local anaesthesia would be enough for the patient. A mild anaesthesia, or in other words sedation anaesthesia could be applied to ensure the patient’s comfort. It would be enough to be over puberty for this aesthetical operation. This operation can also be applied on virgin female individuals since it’s not related to hymen. 3-4 weeks of waiting would be required for active sexual life after the operation.
Tarnishing, browning and darkening might occur in vulva with the effect of oestrogen and sun light. Oestrogen hormone mobilizes the cells that release color pigments on the external genital area (melanocyte) with the effect of sun light and the darkening of color occurs. The fact that the area is covered or hairless doesn’t change the effect of UV irridations of the sun. Other than these; advancing age, hormones used and the creams applied to this area, gynecological operations undergone in the past, polycystic over syndrome, genetic susceptibility might be mentioned among the reasons of external genital area darkening.
LASER VAGINAL REJUVENATION
In laser vaginal rejuvenation, supportive tissue of the vagina which lost its tightness and flexibility is revived. Since it’s not a surgical procedure, it has little risks for the patient, and it’s a painless procedure using advanced technology. The most significant purpose is to increase the sexual arousal, sexual pleasure and orgasm of the female individual. Since the vagina will become tighter, sexual pleasure of the partner will also automatically increase. Eventually, the female individual will have more self-confidence, feel better and have a better sexual life. Apart from that, this procedure can also be applied on the patients with mild urinary incontinence, frequent vaginal infections and vaginal lubrication problems.
The procedure can be applied without anaesthesia or with a mild sedation. It takes around 15-20 minutes. The blood flow of this area is increased, and the synthesis of collagen tissue (supportive tissue) is increased by being stimulated by the use of laser light applied in the vagina. I recommend kegel exercises and/or plates after this procedure. These exercises would strengthen the muscles by increasing the blood flow to the pelvic area (pelvic floor muscles) and genital area.
Additionally, thanks to these exercises, women could learn more about their genital areas anatomically and functionally and feel it better. Apart from this, not only intravaginal, but also vulva tightening is also possible. In case of ptotic labia majores, loose external genital area or wrinkles, tightening of genital area through laser could be tried. A round appearance of the weak vulva is aimed. One or more sessions of laser tightening could be applied in accordance with the level of weakness.
CYSTOCELE (BLADDER-URINE BAG PROLAPSE)
Cystocele is bladder or urine bag prolapse into the vagina. When the prolapse is advanced, it can be visible from the vaginal orifice. Aging, menoposis, multiple deliveries, histerectomy (uterus removal) operation are the risk factors of cystocele. The complaints of a female patient with cystocele are frequent urinating, urinary incontinence, difficulty in urinating, urge to urinate after urination and the feeling of not being done with urinating, nocturia (urinating at night) and pain during coitus. Sometimes the patients complain about feeling of a swell and pressure in the vagina or something that prolapses. Cystocele is diagnosed through physical examination (genital area examination). In addition to that, ultrasound and uroflow and PVR (postvoiding residual) tests are also helpful for the diagnosis.
Mild, unproblematic cystocele might not require treatment (laser vaginoplasty might be tried and be helpful). Advanced and problemativ cystocele should be treated through surgery. Anterior colporrhaphy (pre-repairment) is applied during surgical treatment. Repairment of the bladder and removal of extra tissues are aimed with this operation. Synthetic material called mesh can also be used for the repairment of bladder. Since the treatment of urinary incontinence would continue after cystocele repairment in these patients, sling operations (female urology) in case of urethra prolapse, loosening should be combined with cystocele repairment.
RECTOCELE (ANUS PROLAPSE)
Rectocele is the condition where the rectum, or in other words, large intestines herniate into the vagina. In the cases of advanced rectoceles, it’s seen that the rectocele comes of of the vagina with or without pushing. Rectocele is also caused by pressure increases on the pelvic area and anus due to deliveries, obesity, constipation, chronic cough, excessive pushing. Apart from these, rectocele complaints increase with aging and after menopause. Intestine movements become more difficult and constipation is seen when rectocele is the case. The complaints of the patients with rectocele are difficulty in defecation, pushing, the feeling of not being able to finish defecation, not being able to relax after defecation, urge to fedecate immediately, and gas and abdominal swelling due to initial reasons.
Actually, irritative complaints of the urine that can’t be evacuated are the case for cystocele, and the stool that can’t be discharged are the case for rectocele. Cystocele is the bladder prolapse, while rectocele is the anus prolapse. Rectocele causes the feeling of swelling in the vagina as well. The feeling of having a mess in the back wall of vagina and pain during coitus can also be seen. Diagnosis is easy thorough physical examination. Consumption of liquid and fibrous foods are recommended in the case of mild rectoceles. Vaginal contraction through laser can be tried in the case of mild rectocele. The only treatment option for the patients with too much complaints and advanced rectocele is surgery. Rectocele repairment procedure is called colporrhaphy posterior (post repairment).
Cystocele and rectocele forming and the complaints they cause are similar to each other. Eventually, cystocele is about the front wall prolapse, herniation of the vagina, while the rectocele is about the prolapse and herniation of posterior wall of vagina. They can be observed together rarely.