Has anyone had a vaginoplasty?

[MumtoBen]

I am on the waiting list to have a vaginoplasty in Sept 06, following damage to my vagina (probably from forceps, an internal tear and an internal haematoma) during childbirth in Feb 05. This is an operation to have your vagina reconstructed. Has anyone else had this operation? How long did it take to recover? Was it successful?

I had third degree tearing from forceps and the vaginal repair was dreadful - couldn't have sex at all as I was stitched too tight. I had a Fenton's procedure, where the vaginal section of the repair was cut, scar tissue removed, and then re-stitched. It was under general, as my consultant said it was pretty uncomfortable and no need for the trauma (very relevant after my delivery). I was only under for about 20 mins. I had no pain at all afterwards (very different from after delivery), it healed fast and well, and I am now exactly the same as I was before childbirth. Bloody marvellous!

I nearly didn't go ahead because I found it hard to trust the staff after disastrous management of my labour and delivery. Thank goodness I did.

The only thing is to take good advice if planning another delivery. Repairs to this sort of tissue don't do so well second time around, I'm told. You'd need to talk it through with a consultant obs.

Thanks for comment. I have been told I have to have a c/section next time. I'm not having a Fenton's procedure. I have no tissue or muscle in 1 place higher up, just bone. They are going to try and stitch the muscle on either side back together. The surgeon has never seen a case like this before, so I have to see one of her colleagues first. They are not sure what the chances are of improvement. Glad to hear it healed so quickly, as I am hoping for the same!

Poor you. This is the stuff that doesn't appear in the pregnancy and birth books, isn't it?!

I think you should be able to expect good fast healing. I was told that the pain/length of recovery time after the birth was to do with general forceps trauma whereas the repair is done carefully and slowly so there is minimal peripheral damage/swelling etc. Obviously yours is a bit more extensive than mine, but they sent me home with paracetamol and I didn't even need to take one.

I can't offer any help on your procedure, but I can say that my (excellent) consultant told me they were pretty good at these sorts of repair nowadays. Here's hoping it works out for you as it did for me.

Let's keep bumping this post up the list - there must be someone who has had something similar.

No but are having a rhinoplasty this summer.

That sounds painful.

bump for MumtoBen!

Just wanted to wish you well and wince sympathetically at you :(

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OUCH!

bump again

Hope someone else replies, MumtoBen!

. come on, someone! This lady needs to know about vaginal trauma and reconstruction, LOTS of people have been though this!!!

I had a third degree tear and lacerations which had to be reconstructed, but this was done shortly after the birth, because I had retained placenta and a major PPH. I had trouble getting anyone to tell me what had actually been done and what damage I had sustained - I eventually managed (about 4 days after the operation) to get a midwife to draw me a little diagram with a biro (it was hideously detailed - at least 200 stitches - I felt very violated and shocked, even though I had already had a transfusion)_ I don't have any major problems subsequent to the reconstruction, am fully continent and fairly comfortable, although I do get soreness, stiffness and itching around my period.

I'm sure there must be mums who know much more about this. Keep bumping this and don't worry!

GS xxx

BUMP

bump

Come on ladies! We should be talking about this - if only I had known more about the help available for continence and poor tear repairs, I wouldn't have spent so long feeling inadequate and mutilated, and having to discuss with my husband a life without penetrative sex.

If what my consultant says is true, there'll be lots of you out there who have had this sort of surgery.

Come on - we know you're out there!

The hospital where I gave birth has nearly 5000 births a year. The gynae said only 4 people per year require surgery for vaginal repair and this is always a Fentons procedure. My problem is pain high up and to quote the gynae "this is not a normal pleace for problems to occur after childbirth". Convinced that it was caused by forceps (the doctor used his full body weight when pulling with them). As I had not had an epidural I felt everything (beyond excruciating)and am sure this brutality caused the injury.

My 2nd degree episiotomy was also not stitched. I had an open wound for 3 months. This was difficult to live with and very painful. This has also not healed well and is sore. But the gynae doesn't have any solution for this.

Maybe people just suffer in silence, which accounts for the low number of operations they do. Or maybe I was just unlucky. I have to admit the consultations with the gynae are stressful and humiliating.

sorry you have had such a rotten time, MumtoBen. and quite appalled at the thought of the episiotomy not being stitched up - was there any medical rationale for this? You may find someone who has been through a similar experience or operation on the babycentre boards for "your body after birth" or "difficult birth debriefing". Sorry to hear that you are finding the medical appointments so difficult.

Sorry I haven't got anything more useful to add.

I had a 3rd degree labio cliteral tear and internal lacerations following the birth of my dd (fisrt baby). Trauma was caused because she was compound presentation (hand up by her face) and also due to the speed of her delivery (4.5 hours). I was taken into theatre immediately following delivery for a repair by the on call consultant, but he managed to bodge it. In short he basically stitched it back together but left the majority of the labia "swinging free!!!". It was only because I mentioned it 2my midwife that I was reffered back to the hospital. I was placed on the waiting list and 5months later (when the other repairs had healed)the repair was completed (u could call me an amputee, as I have lost my labia.....tee hee hee). Different consultant did the job (female), and she was Fantastic. I have had no problems since the repair (November 02) and gave birth to a 9lb baby without pain relief or intervention in Aug 05 (another very qick labour at 1.5 hours). My midwife was aware of my scarring, and basically we "supported" the scar area during the delivery (nice image...NOT!) and I gave birth standing up. Good luck with regards to your op, and if you need any advice just ask.

Tearsbeforebedtime. I don't know why it was not stitched. All I know that 1 week after the delivery (I was still in hospital) the pain was so bad I asked to see a doctor. I was only brave enough to look down there and was horrified by the gaping hole. The doctor at the time could not tell me if I had been stitched and it had ripped open or if I had just not been stitched at all. He said it was too late to stitch. I blacked out for an hour or so after giving birth so I just don't know and my husband can't remember what was going on. My gynae has no answers either. I just think it was incompetence. So many things went wrong with my "care" that they have admitted was incompetence that nothing surprises me.

The gynae has said that I should have a c-section next time. The danger is that it would rip open again. I guess unlike you Mrsaek they couldn't support the scarring as it's too far up. And I could not bear another 2 years+ recovery time.

It's encouraging that a few of you have had a good outcome. I have got such a long wait for the operation that I am finding the situation very depressing.

Wow, I'm really glad to have found this. Have been suffering in silence for years. I had a forceps delivery 6 years ago and have found sex virtually impossible since. Whenever I've mentioned this to a nurse, GP etc their answer has always been "relax, use KY" or something equally useless but I know I was basically stitched up incorrectly. The whole area throbbed on and off for three years after the birth, which doesn't seem normal to me. One GP said something about trauma to the internal walls from the forceps taking a long time to heal! I didn't even realise there was such a procedure to repair it all and that anyone else in the country has had the same problem (I tried mentioning it to a couple of friends who looked at me as if I was nuts!) So thank you Mum to Nem for giving me the inspiration to do something about it, and good luck with your op!

thirtysomething - so glad to have heard from someone else with same problem. I was told by the gynae that you should be healed within a year. After that nothing improves. Breastfeeding can apparently delay healing a bit. Have you been able to have a cervical smear test? I was wondering, as I was due to have one a year ago, and can't because it's too painful. I now haven't had one for 6 years. Gynae said I must wait and they can do one at the time of the operation. Ask your consultant for a referral to an Obstetric Gynae. Best of luck.

Its the sort of thing no-one talks about. 3 of 5 of my antenatal class had forceps delivery. 1 woman was left doubly-continent, but she moved away so I never found out what happened in the end, but she was in a bad way. The other women was OK.

Thanks MumtoBen for the smear test info - I have managed to have two in fact, but they weren't what you'd call comfortable (and earnt me a "don't overeact it's only a smear" type dirty look from the very unsympathetic nurse!)

I will definitely pursue this further now - thank you for speaking up about this and I hope you get everything sorted out very soon!

I think I can answer the stitching issue. My episiotomy was only stitched sort of top and bottom, if you see what I mean, leaving the whole middle section unstitched (like you say, basically a hole). I enquired about this when seeing a consultant at 6 weeks, and apparently if you stitch it all then there is a much higher likelihood of it healing too tight or 'pulling' to one side as the tissues tighten following delivery. They reckon they get much better results leaving it free. Mine was actually too tight anyway, but they sorted that at the same time as the fenton's procedure.

Thirtysomething, I know exactly how you feel. I was told by the first consultant I saw that my problems with sex were psychological. His internal exam made me weep with pain, and I am not a weeper, but he claimed that since he could stretch the tissue it meant everything was fine and the problem was with me. I did point out that I am a psychologist, and if anyone would know when a problem was mental in origin it was me, but he gave me a ton of KY and sent me home to 'keep working on it'. Shortly after this, my husband and I decided to give up on sex for good as it was too painful and actually quite traumatic.

Then, when I saw my urogynae about the continence, he asked about sex. On internal exam, he immediately identified the problem (which he told me was quite obvious and not uncommon, and he could not understand why the first consultant had dismissed me). When the stitching had healed, it tightened causing an internal 'band' which was what prevented me from having sex (or even a smear test). The fenton's procedure (which he did in day surgery a few months later) cuts the repair, removes any scar tissue (which can rub during sex apparently) and then re-stitches in the other direction. I'll try to explain. They cut out the repair which for me was along the vertical axis, then stitch the top and bottom of the gap together (i.e. a horizontal repair). I am exactly the same as before delivery now (see my post below).

I couldn't have smear tests either, but my GP was brilliant as we knew what the problem was by then. I bet you've got the same problem. If so, you'll be delighted to hear that it is easy to fix! I wasn't even in pain afterwards (which is more than I can say about the months following the forceps delivery).

DEFINITELY seek a referral.

My episiotomy was not stitched at the top or the bottom. I think it has healed misaligned, the skin is very thin at the top, is very red still (even day-to-day washing, sitting etc pulls it and must be irritating it) and the scar is over 1 cm wide.

bump.

Mum2Ben - have you ever thought of going through your notes with a midwife to get them to explain what happened? or going down the formal complaints route? or even contemplating going down the legal action route, since you feel that you care was substandard?

I made a formal complaint, one midwife apologised for all the lies she told me. The 2nd midwife lied in the response, as much of it is my word against his. He has left the hospital.

I have not mentioned the extent of the incompetence, but some of the major issues are:
Non-stitching of episiotomy
Refusal to believe I was in labour (even when I was 30 minutes into pushing)
Refusal to check my cervix
Refusal to provide any pain relief during entire 1st stage of labour (I screamed in pain for hours - baby was back-to-back and dilating fairly quickly)
Refusal to provide almost any midwifery care through most of 1st stage of labour
Refusal to monitor baby's heart beat during 1st stage of labour (guidelines state every 15 minutes)
Lied to - "gas and air is addictive", "you cannot have a bath as your waters have broken"
Refusal to allow me into the delivery suite upon arrival as I had not telephoned in advance (I had)
Inadequate pain relief during 4 ventouse attempts and forceps (man used full body weight to pull)
SPD not managed during labour, leaving me with long-term problems.
Baby nearly abducted on post-natal ward
Expected to leave baby in incubator on his own during meal times (not allowed to eat on ward)
Blood (not mine) in delivery suite
Blood transfusion bag left in sink overnight 1 metre from my bed
Filthy toilets and showers
Making me walk whilst pushing along a long corridor to a room on the post natal ward (kept collapsing onto floor)
Pushed for 4 hours (guidelines said doctor should be called after 2 hours, as risk of maternal death amongst other risks)

When I first saw a gynae (a junior doctor), he referred me to see a senior gynae who went through my notes with me. She explained some things and has apologised, but I think on some things I have been fobbed off. She also made the Head of the Delivery Suite come to see me at home about the midwivery issues.

I would not qualify for legal aid and so would have to fund it myself and I think I am too late now. Many of the problems have only come to light more recently and it is only now I realise the full extent of the substandard care. I am traumatised just by thinking about it and could not put myself through a court case.

They have said I can have a c-section next time. The Head of the Delivery Suite has promised to do a birth plan with me. I am not sure I can return to this hospital. The long-term injuries to me are bad enough, but they put my baby's life at risk during labour. Luck was on my side and he is OK now though.

How awful for you. Many of the items on your list are exactly the same as happened to me, although the post-natal issues with me were quite different (and due to poor clinical judgement and refusal to believe what I was saying).

My formal complaint was made as difficult as possible, and eventually I did give up because I was unable to move on from the trauma of what had happened (and what COULD have happened, as a result of the poor clinical care). I decided not to sue. This was for two reasons: firstly that I needed to put an end to reliving the episode repeatedly through letters, interviews etc. otherwise I didn't think I would ever put it behind me, and secondly because we were advised that in these cases legal action is all about money, and quantifying how much your physical and psychological injury was 'worth'. Since that wasn't the issue for us (we just wanted proper recognition of the mistakes that had been made, and evidence that they had made changes in the service to prevent the same mistakes being made with someone else), there seemed little point in going ahead.

I wonder if we were at the same hospital?...

By the way, there's a thread about re-doing stitches on the Health board. Not directly relevant to our discussion, but made me think you might get more response about your planned procedure if you posted in health?

sorry to hear about the appalling care you received, mumtoben, and that you weren't satisfied with the hospital's response.. If you were to take legal action you would have 3 years following the birth in which to commence proceedings (possibly a bit longer if the hospital hid things from you, but you'ld need expert advice about that).