Vaginal Advancement is almost the opposite of how we think of vaginoplasty. Instead of tightening the vagina, it involves making the opening of the vagina larger to decrease pain with intercourse especially at the point of penetration. This can be very helpful for patients with small vaginal openings, painful/irritated vaginal openings or vestibulitis.
Patients best suited for this procedure are those that have tried to relieve the pain with intercourse medically without relief. Most of the time these patients have tried many different conservative treatment options, such as antibiotics, antifungals, numbing ointments, neuropathy creams, topical vaginal estrogens, lubrications, pelvic floor biofeedback, and/or vaginal dilation/massage. If these do not work, the surgical alternative of vaginal advancement is effective 85% of the time.
Vaginal advancement usually involves excising the irritated tissue between the hymen and the perineum. Then, the vaginal mucosa (skin) edge is brought forward, to bypass the area of discomfort, and attached to the skin on the perineum. Not only does this eliminate the irritated tissue at the opening, but it effectively enlarges the opening as well, so that these patients can have sex without pain.