Who Should Undergo and Expected Results
How is the Procedure Performed?
The procedure is performed under general anaesthesia. The patient is placed in the same position when a woman gives birth to expose the vaginal and perineum area. The surgeon then examines the whole pelvic area and inserts a catheter to the bladder. A long incision is made around the vagina, and the cut is deepened down to the pubocervical fascia. The surgeon then separates the mucosa from the lateral wall of the vagina. The pudendal artery is identified, clamped, and then tied off. The dissection of the vagina is continued under the urethra and bladder, taking care not to injure the numerous blood vessels in the area.
Another surgeon then performs total hysterectomy by making an incision in the abdominal area. The peritoneal cavity is accessed to locate the vagina and the bladder. The bladder is dissected from the vaginal wall. The surgeon continues the dissection to detach the vagina from the ureters, the cervix, and the rectum.
The whole vagina or a part of it is slowly removed, making sure to avoid injuring nearby parts. If needed, the surgeon will reconstruct the vaginal canal using tissue graft. In some cases, the vaginal canal is completely stitched closed if the patient is not sexually active anymore. Those who are sexually active can choose to undergo vaginoplasty after this procedure to surgically reconstruct the remaining tissue to resemble a normal vagina.
Possible Risks and Complications
As a major surgical procedure, vaginectomy is linked to various risks and possible complications. These include:
• Uncontrolled bleeding during and after surgery
• Infection, which could set in after the procedure. This infection could travel to the bloodstream, leading to a life-threatening condition called sepsis.
• Urinary fistula, which is characterised by the constant leaking of urine caused by an abnormal opening between the urinary bladder and the vagina.
• Rectal dysfunction. Some patients experience chronic leakage of faeces and gas that leads to considerable distress.
• Deep vein thrombosis, which is characterised by pain and tenderness in one or both legs.
There are also reports of groin pain, fever, and urinary tract injury following vaginectomy.