What is a Hymenotomy?
A hymenotomy is a minor surgical procedure that involves removing part or all of a woman’s hymen. It is done for a variety of reasons, most of which have to do with the malformation of the hymen. Some women have this surgery to increase comfort during intercourse, while others need it for health reasons.
Why a Hymenotomy is performed?
A woman requiring a hymenotomy usually has an imperforate, septate, or micro-perforate hymen. An imperforate hymen covers the entire vaginal opening and usually has no holes or perforations. Often this condition is not known until a woman begins to menstruate. If this condition is not corrected the menstrual blood can back up into the uterus and flow out of the fallopian tubes into the abdomen. A septate hymen typically has two small holes parallel to each other on either side of the vaginal opening.
A micro-perforate hymen generally only has one or several very small holes. In all of these cases, a hymenotomy may be necessary to facilitate menstrual flow, make it possible to use a tampon, or to facilitate sexual intercourse. In some cases, young women with relatively normal hymens also require a hymenotomy because they may have a very thick or stiff hymen making sexual intercourse or tampon use very painful or impossible.
- Relief of discomfort that comes from sexual intercourse. Most women choose to have surgery done on their hymen because sexual intercourse has not been able to thoroughly break or stretch the hymen so as to make sex comfortable or pleasurable. When the hymen is worked on, however, after the healing period is complete, a woman can enjoy a very satisfactory sex life. It may be, too, that her hymen has remained intact enough where sexual intercourse actually aggravates the urethra and can cause recurrent bladder infections. In this case, too, surgery on the hymen can bring a lifetime of relief.
- Avoid health problems associated with menstrual flow. In girls and young women just starting their menstrual cycle, they may find that surgery on the hymen is necessary for proper flow of blood. Some girls have no opening at all in the hymen, and so to avoid serious medical conditions and even death that can result from build-up of menstrual blood in the vaginal cavity, surgery on the hymen is crucial.
- Ability to use tampons. Along with the last point, a woman can use tampons much more easily and freely once surgery on the hymen is done. Some women have never been able to use a tampon due to inability to insert it because of the hymen, or fear that it may catch on tissue that may stretch across the vagina. Thus, the procedure brings much comfort and more ease to life when a woman can now use a tampon – think of times you’ve needed to use one when swimming, wearing a bathing suit, or other times!
- Expense/lack of insurance. One of the biggest issues for all people usually comes down to finances or medical insurance’s lack of coverage for the procedure needed. The procedure itself is not that expensive, but it may just be too much for some.
- Discomfort after the procedure. It is true, once the procedure is done and over with, you will experience burning for two months or so later during urination. Your vaginal area is healing itself during this period, and things can be rather uncomfortable. As mentioned, you should probably expect to be uncomfortable for about two months or so.
- Refrain from vaginal sex. For at least two months after the procedure, the woman must refrain from vaginal sex. She is healing, and there should be no aggravation to this healing process. This can be difficult for some people, especially the man, and especially so if vaginal intercourse is the way the two are used to pleasing one another sexually.
How is a Hymenotomy done?
Most hymenotomy procedures are done in a matter of hours. A women will be administered an anesthesia along with a local injection that will numb the vaginal opening. The doctor will then carefully cut away part or all of the webbing covering the vaginal opening, some women prefer part of the webbing to be left in place. This may be a matter of personal preference or for religious reasons. The wounds are then stitched with a fine absorbable suture. These sutures will dissolve on their own.
Women usually experience a fairly fast recovery period. You must keep the area as clean and as dry as possible. Mild cramping and pain is common and Ibuprofen or other NSAIDs can be taken for the uterine cramping. Topical lidocaine jelly is recommended for the vaginal orifice. The patient is instructed to apply the jelly sparingly to the area a few minutes prior to urinating and as needed for soreness. Baths are ok and, in fact, may provide some soothing comfort and help keep the area clean.
Patients and/or parents should call your doctor if they experience severe cramping unrelieved by ibuprofen or develops a fever. Infections and inflammation are possible, but they’re relatively uncommon and usually very treatable.
Make sure to schedule a postoperative office visit 1-2 weeks after your procedure. So that the doctor can check the area for signs of inflammation or infection and make sure you are healing properly.
The information provided on this site is intended to educate the reader about certain medical conditions and certain possible treatment. It is not a substitute for examination, diagnosis, and medical care provided by a licensed and qualified health care professional. If you believe you, or someone you know suffers from the conditions described herein, please see your health care provider immediately. Do not attempt to treat yourself or anyone else without proper medical supervision.
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Dr. Amir Marashi, MD
Brooklyn GYN Place
142 Joralemon Street, Suite 4CF
Brooklyn, NY 11201