Vaginal Reconstruction and Rejuvenation Surgery: Is There Data to Support Improved Sexual Function?

Abstract

Introduction: Vaginal rejuvenation and cosmetic vaginal surgery is one of the latest trends in urogynecology, gynecology, and plastic surgery. There is some confusion regarding what the term “vaginal rejuvenation” means, the surgical techniques and indications for this type of procedure, and how it may or may not differ from standard vaginal reconstructive techniques. There are also questions whether any scientific data are available to support the use of these procedures to enhance sexual function. Materials and Methods: The current paper attempts to answer these questions and reviews the literature regarding this topic. The worldwide literature was searched using PubMed database and reviewed for relevant studies on the effect of prolapse and/or vaginal relaxation on sexual function and whether repair improves any dysfunction present. Results: It is well documented in the literature that pelvic organ prolapse affects sexual function and that when repaired, sexual function improves as confirmed by validated sexual-function questionnaires. Damage to the vaginal walls and pelvic floor following traumatic childbirth may result in vaginal relaxation that may affect sexual function. The damage may not be severe enough to cause true prolapse or incontinence, but it may affect sensation and ultimately female sexual function. Vaginal reconstructive techniques that are designed to repair the caliber of the vagina are termed “vaginal rejuvenation” surgery. Repair of any anatomic changes affecting the caliber of the vaginal canal and perineum have been shown in recent studies to improve sexual function as well. Many women with complaints of vaginal relaxation are also found to have various stages of prolapse, and it is very important to recognize and repair these defects simultaneously as well. Conclusions: Prolapse, albeit a more severe form of vaginal relaxation, when repaired, seems to improve sexual function in many studies. Recent studies also show that vaginal rejuvenation or repair/tightening of the caliber of the vagina prior to the development of prolapse may improve female sexual function. Further studies are warranted in this field.