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Your healthcare provider or surgeon may come to see how you are doing after the surgery and answer any questions you have. , If discomfort to the area persists after a week or two, talk to your healthcare provider as it might indicate an issue. ; This bleeding is typically not heavy. 337 A hymenectomy is a simple surgical procedure to remove the excess hymenal tissue from the vaginal opening. American College of Obstetricians and Gynecologists. Surgical Technique for Imperforate Hymen and Microperforate Hymen I was sore inside for quite some time after the surgery. This includes injury or irritation from an accident, pelvic surgery, female circumcision or a cut made during childbirth to enlarge the birth canal (episiotomy). Often, the doctor will use sutures that dissolve naturally, so you dont have to go back to the clinic to have them removed. Other signs and symptoms such as vaginal discharge, vaginal pain, abdominal pain, and fainting may also be present in such situations. 9500 Euclid Avenue, Cleveland, Ohio 44195 |, Important Updates + Notice of Vendor Data Event. Pain management with nonsteroidal antiinflammatory drugs or a topical anesthetic jelly typically is sufficient. You will want to check with your healthcare provider and insurance company to see if hymenectomy is covered. More than 500 mL of viscous old blood was drained from the vagina, uterus and the right salpinx. In addition, among 17 cases of newborns with a diagnosis of IH before birth, hymenectomy (n = 5, 29.4%) and hymenotomy (n = 9, 52.9%) were the main treatment modalities and showed improved prognosis in 52.9% of newborns. Not taking aspirin, as it can cause bleeding after hymenectomy procedures. Get answers from Gynecologists and top U.S. doctors, Our doctors evaluate, diagnose, prescribe, order lab tests, and recommend follow-up care. ET). . Your health insurance company may need information from your practitioner's office before making a decision, such as whether the surgery is elective or medically necessary. Because I like to learn. In addition, granulation, a type of scar tissue, can form on the vaginal cuff and prevent complete . The ACOG policies can be found on To learn more, please visit our. I had diahreha with blood. While experiencing bleeding, a protective garment such as a towel or pad can be used temporarily to prevent stained . If the patient can tolerate a digital examination, a shortened vaginal canal without a palpable cervix may be consistent with a transverse vaginal septum, cervical atresia, or vaginal agenesis. The surgeon and nurses will get you into a position that will help them perform the surgery. Last reviewed by a Cleveland Clinic medical professional on 12/23/2022. After the hematometrocolpos has been drained, the patient can expect to have an extended bleeding cycle of approximately 2 weeks, which will allow for the involution of the uterus. When examining the patient, downward labial traction can open and separate the labia majora and minora sufficiently to visualize the distal introitus. As a rule, a side effect is represented by problems such as minor hematomas, weak bleeding, discomfort and numbness in the area of the operation. Hold the contraction for five seconds, relax and repeat the exercise. Depending on whether you are in a clinic or hospital, you may be put into a room to wait or sent to the pre-op area, which usually has stretchers divided by privacy curtains. A hymenectomy is a surgical procedure for a medical indication and is unrelated to the patient's decision for future sexual activity. , I asked my mother what it was and she told me. Youll receive local anesthesia to the area around your hymen (the vulvar area of the vagina). Swelling or redness of the legs. In most cases, bleeding will be minimal and will cease sooner. You will also need to use the bathroom before you can be discharged. Management of Acute Obstructive Uterovaginal Anomalies . In these situations, dilator therapy may be considered 5. Some healthcare providers will recommend a topical cream or spray to use in the area. Content on HealthTap (including answers) should not be used for medical advice, diagnosis, or treatment, and interactions on HealthTap do not create a doctor-patient relationship. Ask Your Own OB GYN Question Customerreply replied 1 year ago Ok thanks OB GYN Doctor: Dr.Sawhney, Doctor replied 1 year ago You are most welcome. Ovulation. Video chat with a U.S. board-certified doctor 24/7 in less than one minute for common issues such as: colds and coughs, stomach symptoms, bladder infections, rashes, and more. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. It is important to complete an abdominal and a perineal examination. Often there will be menstrual efflux; however, depending on the degree of perforation or efflux, there may be retained menstrual blood with malodorous discharge, particularly with a microperforate hymen. Apply a numbing cream or spray to the area. A woman's menstrual cycle lasts on average 28 days and ovulation occurs about 10 to 14 days after the start of the menstrual period. By using our website, you consent to our use of cookies. A hymenectomy (also called a hymenotomy) is a minor surgical procedure that opens or removes your hymen. Typically, an imperforate hymen is an isolated issue and does not have long-term effects on fertility, sexual function, or obstetric outcomes. A week or two after surgery, your healthcare provider will want you to come back to the office for a follow-up appointment. The first (male) said that surgery was available, but he implied that it would require general anesthesia, etc. Scared me to death to think someone else was going to poke and prod me, fear stemming again from the abuse. Created for people with ongoing healthcare needs but benefits everyone. Should I call my doctor? These disorders can affect menstruation and sexual intercourse. Talk to your healthcare provider at your follow-up appointment about any discomfort or pain youre feeling. To determine if your hymen is causing issues with using tampons or having sex, your doctor will perform a vaginal exam. This helps keep the area clean and free from infection and also helps the surgeon focus on the area where they are performing the procedure. It's heavy. could i get pregnant having an elastic hymen ? Most people who were unable to have sex, use a tampon, or menstruate before having a hymenectomy are relieved when these activities become a regular, painless part of their lives. ), Figure 5. She is also the author of "Ask Me About My Uterus: A Quest to Make Doctors Believe in Women's Pain.". 16 Families may need to be reassured that virginity is not affected by hymenal surgery. I met someone when I was 17 and a year later after becoming very close and bonded we both felt comfortable enough to try and thats where my troubles started. You may be told to fast completely starting the night before your surgery. This information should not be considered as inclusive of all proper treatments or methods of care or as a statement of the standard of care. They may give you an idea of when you can resume your normal activities or return to work, or they may want to wait until they see you at your post-op appointment in a week or two. Hello, You may call me Charlotte. Then, youll get sedative medication or anesthesia. These risks include: After a septate hymen surgery, it can take several weeks before you can resume your regular routine. Silveira SA In some cases, you may have lingering discomfort for a couple of months. If you receive a bill after you have had surgery and are concerned about how you will pay, you may also be able to talk to the billing department of the healthcare system where the procedure was performed. The traditional method of hymenectomy entails making a cruciate incision (cross-shaped) over the hymenal tissue with excision of the quadrants and approximation of the hymen edges to the vestibule with absorbable sutures. Relief of problems associated with having your vaginal opening blocked. Presenting and long-term clinical implications and fecundity in females with obstructing vaginal malformations Follow-up after hymenectomy: After hymenectomy, the patient will be monitored by a nurse within the first 24 hours after surgery. Other findings that may be present include an abdominal mass, urinary retention, dysuria, constipation, and dyschezia. You will be given a gown to change into when you arrive at the hospital, but you should still wear or bring something comfortable to wear when you go home. Get prescriptions or refills through a video chat, if the doctor feels the prescriptions are medically appropriate. To facilitate normal menstruation, an opening needs to be created in the hymen before someone gets their first period. You should see your doctor if this continues or you Copyright 2019 by the American College of Obstetricians and Gynecologists. Schedule a follow-up appointment with your healthcare provider. Your hymen is flexible, thin and stretches over time. (https://pubmed.ncbi.nlm.nih.gov/30173591/), (https://www.racgp.org.au/download/documents/AFP/2011/November/201111asmith.pdf), (https://casereports.bmj.com/content/casereports/2016/bcr-2016-215124.full.pdf), Visitation, mask requirements and COVID-19 information. Informing medical teams of these risks might promote early detection and minimize associated complications such as laceration-associated blood loss and preterm delivery. Although stenosis and adhesions have been reported after hymenectomy, these complications are extremely rare. The redundant hymenal mucosa should be excised, and the mucosal edges may be reapproximated using a 3-0 or 4-0 absorbable suture in an interrupted fashion for hemostasis. Management of acute obstructive uterovaginal anomalies. Created for people with ongoing healthcare needs but benefits everyone. Atlas of Pelvic Surgery. If you have any other health conditions, especially those that affect how your body clots blood, you may need to take other precautions prior to surgery. You might feel slight discomfort in the vaginal area for a few days after surgery. 1B). Vaginal bleeding that begins immediately after hysterectomy and continues for more than 6 weeks after surgery should be considered seriously. She serves as an assistant professor at the Yale School of Medicine, and practices in Bridgeport, Connecticut. It is normal to have vaginal blood loss and discharge for several weeks after a hysterectomy, according to the. You will receive sedation and anesthesia before the procedure begins, so you won't be awake or remember what happens during the surgery. In other cases, high-intensity physical activities like exercise or athletics may contribute to breaking the hymen. Light bleeding about one week or two weeks after the end of your period could be due to ovulation. Using an ice pack to reduce swelling around your genitals. I had diahreha with blood. 2016 When the hymen only has a small opening (a microperforate hymen), the surgery can be used to alleviate pain and discomfort. Obstet Gynecol 2019;133:e3726. Doctors may recommend minor surgery to correct an abnormal hymen either at birth or as soon as it causes issues. Answer (1 of 4): There are several things that should be checked. What Are The Most Common Hymen Myths? In the weeks and days leading up to your surgery, if you are sick or get an infection, let your healthcare provider know. Hymenectomy is done when there is an imperforate hymen because blocking the opening of the vagina may cause problems such as: A buildup and trapped mucus in the vagina (mucocolpos) A buildup and trapped menstrual blood in the vagina (hematocolpos) A buildup and trapped blood in the uterus (hematometria) Hymenectomy Procedure 3. Imperforate hymen is not associated with concomitant uterine anomalies 3, and, therefore, in the absence of symptoms, postoperative uterine imaging usually is not required. Youll have a follow-up appointment with your healthcare provider within two to four weeks. Obstetriciangynecologists should be aware that families may need education about the hymen and its role in sexual function. It is important to note that a microperforate hymen or septate hymen may not present as an obstruction. A urethral catheter should be placed preoperatively or intraoperatively to confirm the exact location of the urethra 1. Theyll numb the area and use a scalpel or surgical scissors to cut the connecting tissue and then use stitches to close the incision points. It is not normal to have bleeding more than that after the surgery of hymenectomy. In rare cases, blood building up in your abdomen is life-threatening. I've a tight hymen.my gynecology scheduled me for a hymenectomy.i'm afraid.will it cause a scar?& will i bleed a lot?how long the procedure take. 780. . A nurse will monitor your vital signs, such as your blood pressure, as you wake up from anesthesia. Alliance for Innovation on Women's Health, Postpartum Contraceptive Access Initiative. Distal vaginal atresia will appear as pink mucosa without discoloration Figure 3 There is no opening whatsoever. Call your healthcare provider or seek medical attention right away if you: If you are sexually active, your healthcare provider will give you very important instructions about having intercourse after your surgery. Most people dont realize that they have a septate hymen until they begin menstruating or try to have sex. (Image courtesy of Anne-Marie E. Amies Oelschlager, MD, University of Washington, Seattle, Washington. The most common reasons for a hymenectomy include: For people with an imperforate hymen (one that completely covers the vaginal opening), a hymenectomy can reduce the risk of developing serious health complications such as infections or abdominal pain from blocked menstrual flow. American College of Obstetricians and Gynecologists. , my h-m-nek-t-m. : Sept 2018;1-5. doi:10.1080/14767058.2018.1519539. Would have your doctor check you and also check for issues with coagulation. 780. After the surgery, you can expect to menstruate normally, use a tampon and have pain-free sex. All rights reserved. You may also find it helpful to read, do a crossword puzzle or word search, listen to music, or just rest quietly. While every surgery has risks and the potential for complications, most people who have hymenectomies do well after surgery and recover without any longterm problems. The additional pressure may cause bleeding to start again or become heavier. ACOG Committee Opinion No. You should see your doctor if this continues or you are having pain. ABSTRACT: At puberty, a patient with an imperforate hymen typically presents with a vaginal bulge of thin hymenal tissue with a dark or bluish hue caused by the hematocolpos behind it. Miller RJ Pelvic Inflammatory Disease (PID), which is an infection of the uterus (womb . ), Figure 6. Typically, the hymen is a small doughnut-shaped ring of tissue that encircles the opening of the vagina. Causes of Bleeding After Sex The most common causes for vaginal bleeding after sex both start in the cervix, which is the narrow, tube-like end of your uterus that opens into the vagina. Cleveland Clinic is a non-profit academic medical center. If you prefer, you can also bring a tote bag or knapsack large enough for these items, which can be left with the person who accompanies you. If the vaginal cuff has not healed completely, some bleeding can occur during intercourse as those tissues can be more fragile. infectious disease characterized by a rapid onset of symptoms, including high fever, skin rash, diarrhea, vomiting, and myalgia, followed by hypotension leading to shock and, in severe cases, death; has been linked to noncotton tampon use and is usually caused by Staphylococcus aureus; abbreviated TSS. This information is designed as an educational resource to aid clinicians in providing obstetric and gynecologic care, and use of this information is voluntary. The size, shape or thickness can prevent them from having normal menstruation, inserting a tampon or having sexual intercourse. A correction notice has been issued for this document on the Obstetrics & Gynecology website. Although a hymenectomy is a minor surgery, there can still be some associated risks. plural hymenectomies. Surgical management of clinically significant hymenal variations involves excision of the hymenal tissue and rarely is associated with long-term sequelae. From Mayo Clinic to your inbox 19 Your healthcare team will go over these risks with you before you have the procedure. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. Learn how we can help The presentation and management of clinically significant hymenal variations differs depending on the age of the patient at onset of symptoms and associated complications. Allergic reaction to the medications used. If there is concern that the patient has a distal vaginal atresia or a transverse vaginal septum, the patient should be referred to a center with expertise in the management of these conditions. 2 doctor answers 2 doctors weighed in Share Dr. Scott Swope answered Family Medicine 61 years experience Yes: There are several reasons this might occur. Other symptoms that a person with a condition affecting their hymen may experience include: If a person is found to have a condition affecting the hymen, surgery is usually necessary. You will receive anesthesia, sedation, and other forms of medication. Take extra care when washing and drying around the. https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Adolescent-Health-Care/Diagnosis-and-Management-of-Hymenal-Variants?IsMobileSet=false milicent634 13M subscribers in the TwoXChromosomes community. Imperforate hymen. If you experience any of the following symptoms, it may be a sign of an infection. Your healthcare provider may recommend a hymenectomy to treat these congenital hymenal conditions: Some hymen abnormalities are discovered at birth, while others arent diagnosed until puberty when a young person has issues with menstruation or inserting a tampon. If discomfort to the area persists after a week or two, talk to your healthcare provider as it might indicate an issue. https://www.stgeorgesurgical.com/procedure/hymenectomy/ It is FREE! American College of Obstetricians and Gynecologists 409 12th Street, SW, PO Box 96920, Washington, DC 20090-6920. For products jointly developed with other organizations, conflict of interest disclosures by representatives of the other organizations are addressed by those organizations. Significance of topical estrogens to labial fusion and vaginal introital integrity To learn more, please visit our, There are several reasons this might occur. . In the rare occasion the procedure is performed in a prepubertal patient, application of a short course of topical estrogen cream to the surgical site may be given to enhance healing and decrease the likelihood of stricture formation and subsequent stenosis 4. If you have any questions or concerns about your hymenectomy recovery, call your doctor.