After childbirth, the opening to the vagina can stretch. If there is laxity at the opening, it is usually from separation of the small muscles which form the back wall of the vagina. This can create a sensation of looseness as well as decreased sexual satisfaction. If it is associated with laxity in the front (cystocele) or back (rectocele) walls of the vagina, a woman can feel a sensation of bulge as well as urinary and/or defecatory symptoms. These can be addressed together. While pelvic floor physical therapy helps by allowing the vaginal muscles to restore tone in the vaginal canal, it may not help to address changes that have occurred in the tissue.
Some women may also have a scar from a previous episiotomy which is either painful because it does not allow the skin to stretch during intercourse, or does not allow the strong muscular tissue on either side to form a more supportive back wall.
How do I get back my pre-childbirth vagina?
Dr. Kumar can address laxity at the vaginal opening by performing a non-mesh surgery called perineoplasty. This outpatient surgery removes the lax skin from the back wall and brings back together the muscles and connective tissue so that the vaginal opening is back to a pre-birth size. It is similar to plastic surgery in that it involves removal of lax skin and tightening of the supportive tissue. Dr. Kumar may recommend doing a bladder lift or posterior repair at the same time, depending on your anatomy and symptoms. If you are suffering from a sensation of vaginal looseness, bulge in the vagina, or urinary symptoms, please make an appointment to see Dr. Kumar for a consultation so you can discuss all your options.
These are done in a 1-2 hour surgery, and Dr. Kumar does not use mesh or other graft material.
What about non-surgical options?
While some energy-based therapies such as lasers are marketed for non-surgical vaginal tightening, they can only help to increase vaginal tone if there is very subtle laxity. There is benefit to the tissue quality from the regenerative effect the devices have, but they do not achieve the same results as a surgical procedure.