Management of vaginal laxity through bilateral wall tightening without mucosal excision

Background Vaginal tightening or vaginoplasty has been gaining popularity, while validated methods of evaluation and treatment are still lacking. Herein, we describe a bilateral wall tightening technique for vaginal laxity and evaluate the feasibility of this method. Methods From April 2020 to September 2021, 25 women with vaginal laxity underwent vaginal tightening, and 22 women were included in this retrospective observational study. The inclusion criteria were as follows: participants with at least one delivery and reported vaginal laxity, but without a history of underlying diseases. Vaginal pressure tests and questionnaires were used to evaluate vaginal laxity and sexual quality before and 6 months after the surgery. Results The study included 22 women (aged 29–46 years), and the follow-up period was 14.1 ± 3.3 months. The score based on the vaginal laxity questionnaire was improved as a result of surgery (preoperative median: 2.00, interquartile range [IQR]: 1.00–2.00; postoperative median: 5.00, IQR: 5.00–6.25, p < 0.001). The vaginal pressure increased from 2.3 ± 1.8 mm/Hg to 21.4 ± 3.7 mm/Hg. Sexual distress changed from 24.2 ± 8.9–16.1 ± 4.8 after surgery (p < 0.001), and sexual dysfunction with an average score of 20.1 ± 10.6 before surgery improved after the procedure (26.0 ± 10.8, p < 0.001). Women also reported improved scores in desire, arousal, orgasm, and satisfaction. In addition, there were no intraoperative complications or significant events during the follow-up period. Conclusions Bilateral vaginal tightening without mucosal excision is a feasible and effective surgical approach for the management of vaginal laxity.

背景 阴道紧缩术或阴道成形术越来越受欢迎，但仍然缺乏经过验证的评估和治疗方法。在此，我们描述了一种用于阴道松弛的双侧壁紧缩技术，并评估了该方法的可行性。 方法 2020年4月至2021年9月，25名阴道松弛的女性接受了阴道紧缩术，其中22名女性被纳入这项回顾性观察研究。纳入标准如下：至少有一次分娩且自述阴道松弛，但无基础疾病史的参与者。在手术前和术后6个月，使用阴道压力测试和问卷调查来评估阴道松弛情况和性生活质量。 结果 该研究纳入了22名女性（年龄29 - 46岁），随访期为14.1 ± 3.3个月。基于阴道松弛问卷的评分因手术而得到改善（术前中位数：2.00，四分位间距[IQR]：1.00 - 2.00；术后中位数：5.00，IQR：5.00 - 6.25，p < 0.001）。阴道压力从2.3 ± 1.8 mmHg增加到21.4 ± 3.7 mmHg。术后性困扰从24.2 ± 8.9变为16.1 ± 4.8（p < 0.001），术前平均得分为20.1 ± 10.6的性功能障碍在术后得到改善（26.0 ± 10.8，p < 0.001）。女性在性欲、性唤起、性高潮和满意度方面的评分也有所提高。此外，在随访期间没有术中并发症或重大事件发生。 结论 不切除黏膜的双侧阴道紧缩术是一种治疗阴道松弛可行且有效的手术方法。