What is Vaginectomy: Overview, Benefits, and Expected Results

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What is⁣ a Vaginectomy? Overview, Benefits, and Expected Results





A vaginectomy is a surgical procedure that removes part or all of ​the vagina.‌ It is usually performed as part of gender confirmation surgery, for medical reasons, or after a traumatic event. This article will provide an overview of vaginectomy,‌ the ⁤benefits, and ⁣the expected results.



Overview of ‍Vaginectomy





A vaginectomy is a surgical procedure that⁤ removes part or all of the vagina. The surgery can range from partial to complete ‍removal of the vagina, and it is ⁤typically done in a hospital or clinic setting. It is usually considered a major⁤ surgery and​ is done with general or spinal anesthesia.⁣



The goal of the‍ surgery is to remove the vaginal‌ skin and tissue, which can be done through different types of surgeries. A‍ partial vaginectomy ​is when only part of the‍ vaginal wall ‍is removed, and⁣ a total vaginectomy is when all ​of the vaginal wall‌ and lining is removed.



There are a ​few different⁢ types of vaginectomy that a⁣ doctor or surgeon may choose, depending on why the surgery ⁢is being performed. For example, one type of‌ vaginectomy, known as a Marlinspike vaginectomy, is ⁢used to treat‍ vaginal prolapse. A‍ partial vaginectomy can also be used to treat prolapse, as well as cancerous or precancerous lesions. Other surgeries, such as clitoral recession, may also be‌ performed in combination with a vaginectomy.



Benefits of a Vaginectomy





The ​primary benefit of a vaginectomy is the removal of ‍any abnormal ⁤tissue or growths in the vagina. This can help to​ reduce⁣ the risk of certain medical issues such as vaginal cancer,⁤ as well as help to reduce the symptoms associated with certain ​conditions, such as discomfort ‌or pain.



In the case of gender reassignment surgery, a vaginectomy ⁣may⁣ help to reduce gender dysphoria by transforming ‌the anatomy to more closely⁣ resemble the desired gender presentation. In this case, a​ vaginectomy can be used to create a flat surface in place of the ⁣vaginal ⁢canal.



Expected Results of a Vaginectomy





The expected results of⁤ a⁢ vaginectomy depend on the type of surgery, as well as ⁣the reason⁣ for having the surgery. Generally, if the surgery is successful, the patient should not have⁢ any ⁤feeling or ⁣sensation in the vagina, and‍ there will be no⁢ visible ⁤sign of the vagina. In a partial vaginectomy, the patient may still have ‌some sensation, ‍but in most cases, the ‌sensation will diminish over time.



In cases of gender reassignment surgery, the expected result of⁤ a vaginectomy is a⁣ lack of a visible ​or noticeable vagina. Many ​of ⁢the transgender individuals who ‍have undergone‍ gender⁢ reassignment surgery report feeling happier and more confident in their identity.



Recovery Time





The​ recovery ​time for a vaginectomy depends ⁤on the type of surgery ⁣and ​the overall health of the patient. Generally, the patient‍ will need to remain ‍in the hospital for a few days after the surgery, ⁤during ⁣which time they will‌ receive medication and rest. The patient may also‌ need⁢ to wear a compression garment for a ‍few days after the ⁤procedure.



The patient may also need‌ to take⁤ antibiotics ​for a few weeks ⁤after​ the procedure, and follow their doctor’s instructions⁣ for proper wound care. Most patients are able to return to their normal activities within a few weeks.



Risks and Complications





As with⁤ any surgical procedure, a vaginectomy carries some risks and potential complications. The risks of the surgery depend on the type ⁤of surgery being performed, as well as the overall health of the patient. Common risks ‌include infection, bleeding, and nerve damage. In‍ rare cases, the patient may experience chronic pain or scarring.



It is important to discuss ⁢the potential ‌risks and complications of the surgery with your doctor before ⁤undergoing the ⁣procedure.⁢ Additionally, it is important to follow all post-operative ‍instructions ​from your doctor in order‌ to reduce the ‍risk of complications.



Conclusion





A vaginectomy is ​a surgical procedure ‍that removes part or all of the ⁣vagina. ⁣It is typically performed for medical reasons, as⁢ part of⁣ gender affirmation surgery, or after a traumatic event. The surgery can range ​from partial to complete removal, and it is typically done with general or spinal⁢ anesthesia in⁢ a hospital or clinic ​setting. The primary benefit​ of a ⁣vaginectomy ‌is the removal of any abnormal tissue or growths in the vagina. Potential risks or complications should be discussed with your doctor⁤ before undergoing the surgery.​ Generally, the patient should be able to return to their​ normal activities within a few weeks.

Definition & Overview

Vaginectomy is a surgical procedure used to treat vaginal cancer or as a part of gender reassignment surgery. It can be partial or radical. It is radical if the whole vagina is removed, or partial if only the upper part of the organ is removed. Most of the time, it is performed with total abdominal hysterectomy.

Who Should Undergo and Expected Results

Vaginectomy can be recommended to patients diagnosed with:

  • Vaginal cancer – Vaginectomy is used to remove cancer cells in the vagina. There are several types of vaginal cancer, classified according to the origins of cancer cells. These are:
  1. Vaginal squamous cell carcinoma, which originates from the squamous epithelium that lines the surface of this organ. This is the most common type of vaginal cancer.
  2. Vaginal melanoma, which arises from melanocytes, the cells responsible for pigmentation.
  3. Vaginal adenosarcoma, which begins from the glands located on the surface of the vagina.
  4. Vaginal sarcoma, which is due to the abnormal growth of connective tissues and muscles in the walls of the vagina.


All these types of vaginal cancer have similar symptoms. These include bleeding, abnormal and odorous discharge, the growth of tissue mass, pelvic pain, and pain during sexual intercourse and urination.

  • Severe lichen planus in the vulva and vagina – In such case, vaginectomy is considered as the last resort if topical treatments are not effective. Patients with this condition suffer from pain and soreness in the vaginal area. If left untreated, it could lead to labial adhesions and narrowing of the introitus.

  • Vaginal prolapse – This is a condition in which the uterine and part of the vagina descend because the tissues that support them have weakened. This displaces the organ resulting in patients having difficulty moving or holding their urine.

  • Benign tumour growth in the vagina.


The procedure is also a part of a gender reassignment surgery where the vagina is removed before a penis is surgically constructed.

Vaginectomy is a major surgery that requires hospitalisation. Its success in treating cancer patients depends on the extent of the disease. Patients with localised cancer with no indication of metastasis have better chances of complete cure. Many patients have expressed satisfaction over the results, especially if reconstructive surgery is also performed after the procedure.

Patients are advised to rest for several weeks after the surgery and to have scheduled check-ups with their physicians for monitoring. Strenuous physical activities and sexual intercourse are to be avoided for several weeks to facilitate healing. Patients are also encouraged to undergo physical therapy.

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.

References:

  • Weitzel HK, Jaluvka V, Opri F: [Colpohysterectomy: A contribution to gynecologic geriatric surgery]

  • Hohlweg-Majert VP, Pohl R, Heyl V: [Hysterocolpectomy: The method of choice in genital prolapse in geriatric patients] Hysterokolpectomie. Fortschr Med 104:21-22, 1986.

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