Hymenoplasty in Thailand

Hymenoplasty, often referred to as hymenorrhaphy, hymen reconstruction, hymenal refashioning, or revirgination, is a surgical intervention performed to restore or repair the hymen.

The hymen is a delicate, circular fold of mucous membrane that is composed of epithelial and connective tissue. It has a limited number of blood vessels and a small amount of nerves, some of which are not associated with the sympathetic nervous system. The hymen typically undergoes rupture or tearing, resulting in bleeding, during a woman’s initial sexual intercourse or in response to different forms of stress. The rupture of the hymen does not undergo spontaneous healing.
Women who have a hymenal cleft resulting from sexual intercourse, trauma, intense sporting activity, or surgical treatments are eligible for hymenoplasty.
Women who have undergone several hymen repairs, have a history of vaginal or induced delivery, or have medical issues such as venereal disease, vaginal infection, or diabetes are not eligible for this surgical procedure.

Preoperative preparation
During the consultation, a comprehensive evaluation will be conducted, which includes an assessment of the patient’s medical history (including allergies, significant medical conditions, and all medications taken, whether prescribed or non-prescribed), a physical examination, and laboratory tests.
 Smoking must be avoided for around 3-4 weeks before to surgery, as nicotine interferes with circulation and will drastically damage healing process.
 It is quite probable that you will be instructed to abstain from consuming alcohol starting one week prior to the surgery and continuing throughout your recuperation period.
It is advisable to refrain from consuming any medications, including hormones, anticoagulants, anabolic steroids, and supplements, for a minimum of 4-6 weeks before surgery to avoid any potential medical complications. Refrain from consuming aspirin, anti-inflammatory medications, and herbal supplements, as they have the potential to heighten the risk of bleeding.
 Abstain from sexual intercourse on the night before to the procedure.

Throughout the course of the procedure:

The patient is positioned in the dorsal lithotomy posture. The perineal area is disinfected with iodophor solution and covered with a sterile drape. For this procedure, it is recommended to use local infiltration. The surgeon administers local anesthesia. The labium minus edge is stitched to the lateral border of the labium majus in order to achieve complete closure.

Examine and hymen. Local anesthetic is administered to both edges of the hymenal cleft.
Hymenal tears or clefts can be surgically repaired by bringing the edges together. The technique for approximation entails generating two imperfections on the side surface of one edge and on the inner surface of the other edge. The epithelium will be excised with a width of approximately 2-3 mm. The mucosal margins are approximated with 6-0 absorbable interrupted sutures.
If the gap between the edges of the hymenal cleft is greater than 2mm or if the edge of the hymenal cleft is less than 2mm thick, simply bringing the edges together may not be sufficient. In such cases, a local transposition flap is required.

The transposition flap procedure involves the creation of two defects: one on the internal surface of one cleft edge and another on the lateral portion of the vaginal vestibular mucosa. Once the new flap defect for the medial flap has been closed, the flap is next rotated to cover the medial defect of one cleft edge. The flap’s proximal portion is stitched to the defect margin of the opposite cleft edge. The lateral flap is pivoted to conceal the lateral imperfection on the opposite cleft edge, and the upper portion of its adjacent border is stitched to the imperfection on the opposite side of the split. The central sections of the upper edge of the two flaps located between the two separated edges are stitched together. The lateral flap’s new defect is closed directly. To prevent the formation of dog-ears, the triangular section of mucosa at the tip of the new flap flaws is surgically removed.
When there are several clefts, surgeons typically prioritize repairing only two or three clefts in order to avoid excessive tension on the incision.

Risks and Complications: Complications associated with hymenoplasty are often mild and can be easily controlled. Odynuria may occur in certain people, although it often resolves once the incision has healed. Most instances did not experience bleeding, significant postoperative discomfort, infection, uroschesis, rectal fistula, or retention of the menses.

Recovery and treatment after surgery:
No more dressing is necessary. Patients are advised to gently cleanse the perineal area, particularly the vaginal opening, with iodophor solution after urinating and defecating. The patient is able to take a bath on the second day after the surgery. Patients should avoid engaging in strenuous exercise, squatting, straddle motions, and riding activities. Postoperative consultation scheduled for 7 days after surgery.