Vaginoplasty (also known as posterior colporrhaphy) is a procedure to tighten the vagina. An alternative is noninvasive vaginal tightening by heating the tissue with radiofrequency waves or laser. Patients with significant sagging may not benefit from these treatments and are better candidates for surgical tightening with vaginoplasty.

After childbirth, women may complain of vaginal laxity resulting from stretching of the tissues and separation of the muscles, sometimes to the point that a tampon falls out, and this lack of tightness can contribute to sexual dysfunction.

During a vaginoplasty, the separated muscles are brought together and the excess mucosa on the back of the vagina is removed. The outer skin may also be removed for a more esthetic appearance.

Although vaginoplasty can be performed under local anesthesia, many choose to undergo general anesthesia.

Once the extent of the tightening is determined, a pie-shaped wedge is marked to delineate the extra skin to be removed inside the vagina. Below the skin, the tissue is tightened with strong sutures. Once the vaginal canal is tightened, the mucosa is sutured closed. If the outer skin protrudes, this can also be reduced for an esthetic result.

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