In women, the area between the vaginal opening and anal opening is called the perineum. Childbirth is the most common reason for the skin to stretch and tear. The muscles the muscles at the back wall of the vagina can also separate, causing an enlarged vaginal opening. Symptoms can include:

• Vaginal laxity or looseness
• Inability to wear a tampon or ring
• Lack of sensation or friction during sexual activity
• Trapping of air in the vagina

If this tissue is damaged, an outpatient surgical procedure called perineoplasty can improve these symptoms. Women undergo perineoplasty to strengthen and tighten the perineum, narrow the vaginal opening, and repair loose or scarred tissue around the vaginal opening. The surgery also involves reattaching the perineal muscles back together to restore the vaginal opening back to a pre-birth diameter.