Hymen

Virginity in some cultures is still a social necessity.
Sometimes the problem is a hymen that is too thick and fibrous which creates pain in intercourse

Reconstruction of the hymen

Indication

hymen interrupted

Surgical technique

hymenoplasty

Procedure

20 min, local anesthesia +/- light sedation, day hospital or outpatient

Complications

rare (infections, delayed healing)

Postoperative pain

very scarce

Recovery

2/4 weeks

Piccole labbra troppo grandi ridotte senza incisioni

Indicazione
piccole labbra troppo grandi (ma non troppo)
Tecnica

riduzione ottica per aumento delle grandi labbra con lipofilling o acido ialuronico

Procedura
10/20 minuti, anestesia locale, ambulatoriale
Dolore
scarsissimo
Recupero
0-2 giorni

Hymenoplasty: Our experience, what we think

In the newspapers we often talk about hymens, about the restoration of virginity, about Italians who increasingly request this type of procedure. In 15 years of intense activity in the genital field, I have only had one Italian patient, who was also suffering from significant mental disorders, who asked me to reconstruct her hymen, which I obviously refused. The patients who come to me for hymenal reconstruction almost always come from North Africa, rarely Asia, sometimes from Eastern Europe (especially the Roma community). Among these populations, virginity is a social value that is often held in high regard. Marriages are agreed upon by each other’s families often at an early age. Life then leads to parting ways until the fateful moment in which he is asked (the only woman!) to account for his purity. A true story: a few years ago a 27-year-old Moroccan girl with a brilliant degree in language in Turin came to visit me in my studio. His family moved to the Cuneo area about 20 years ago. His father was a house painter, his mother was a housewife, his brothers were bricklayers. But she loved studying and was brilliant and her parents supported her choice. Before leaving Morocco the family had agreed on a marriage for her and her brothers. In her case the wedding had been postponed for a few years to allow her to graduate. And she had graduated with honors, found a job in a tourist agency and had set up a happy and independent life. One day the brothers knocked on her door and told her it was time to return to Morocco and get married. Her partner had been waiting impatiently for her for almost 20 years. He had built a house 50 km inland from Essaouira, a beautiful location on the Atlantic. The village had 3000 inhabitants, he was a baker. Amina hadn’t had any big affairs or even boyfriends for fear that the family would revolt. However, she had had intercourse and was no longer a virgin. When she asked me to reconstruct her hymen and she asked me in a kind, polite, affable way, in perfect Italian respecting the subjunctives and conditionals and the most rigorous courtesy formulas, it came naturally to me to ask her her story because I found it hard to believe. that an emancipated woman in my eyes wanted to undergo a procedure that culturally we struggle to understand. Amina replied to me that if she hadn’t married that man, who she didn’t love, but defined as a good Christ, the family would have repudiated her, she would have had to abandon her lifelong affections and forget about family ties. He also told me that neither his brothers nor his father would raise their hands. In short, it was a free and tragically conscious choice: forgetting her degree, emancipation and the Turin gianduiotto to move to a small country village with a man she had met as a child. And all this so as not to lose the bond with the family. “Amina, are you sure you’re doing this shit?” I asked her. The answer was peremptory: “Family bond comes first.” I operated on Amina who got married, lived in Egypt for three years and then fled to Italy.

 

 

Introduction

The hymen is a fibrous structure that separates the vulva from the vaginal access. Its perforation during the coital act causes fragmentation into multiple flaps. The reconstruction of the hymen is carried out by stitching together the separated edges. The surgeon must have the foresight to carry out a procedure that is both effective and free of complications during intercourse. In fact, it is sufficient that resistance is guaranteed during the procedure and a fair amount of bleeding occurs. The expert surgeon will avoid reconstructing an excessively rigid, fibrotic and difficult to penetrate hymenal ring.

Anatomy

The hymen is a fibrotic structure of variable size and shape that separates the vulva from the vaginal access. In some cases the structure is almost non-existent, in others it forms an important separation wall.

Procedures

The correction is carried out by joining the main hymenal flaps in order to guarantee a reconstruction that is as effective as possible and as painless as possible during penetration. The expert surgeon will be able to play with prestige so that the structure is recomposed in the most correct anatomical way but not in such a way as to create fibrotic problems which can prove to be quite problematic during the penetration arc.

How the interventions happen, what to expect

It is necessary to undergo preoperative blood tests and an electrocardiogram. Hair removal is not necessary and will be carried out in the operating room only if necessary. Most procedures are performed under local anesthesia with sedation, meaning the patient is deeply sedated and has no memory of the procedure. In some cases the procedure can also be carried out under local anesthesia if the patient is particularly cooperative or willing to interface with the surgeon during the operation. It is also possible to resort to general anesthesia with intubation but this method has no advantage over deep sedation but on the other hand is characterized by a longer and more complex observational postoperative period. So it’s not worth it. The pain in the immediate post-operative period is very low, while the pain in the following days is well controllable with common painkillers. In some cases, which are very rare, it is possible to resort to more painkillers capable of extinguishing any discomfort. Home management requires daily washing with disinfectant douches. It is possible to take a shower from the following day. 1/2 days of rest from common work activities is useful. Sexual intercourse must be avoided for a month as well as cycling for 2. The resumption of sporting activity takes place within 10 days, avoiding all those positions capable of causing tension or pressure on the operated anatomical part. After 2/3 weeks it is useful to start massaging the operated part in order to soften the scars. Hyaluronic acid implant procedures are instead performed under pure local anesthesia.

Risks and complications

The risks are dictated:
1) from failure to achieve the result: this happens when the hymenal caruncles, or the flaps that destroy the hymen, are not joined in the correct way. This determines insufficient resistance during the coital act and the failure to release drops of blood which for some seems to have such an important role;
2) reconstruction of an excessively rigid hymenal wall: this is a problem that can have unpleasant consequences and requires reoperation. It occurs when the hymen is reconstructed by excessively tightening the flaps and resulting in the formation of a rigid and non-perforable hymenal ring. In this case the sexual act cannot take place because the hymen cannot fragment because it is excessively stiff. Treatment consists of softening the hymenal structure.

Pre e Post

Prima
Dopo
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