PELVIC SURGERY CONTROVERSIES

Repair of a constricted or shortened vagina: What works?

Iatrogenic damage that does not yield to estrogen cream or dilators requires individualized surgery

Director of Urogynecology, Good Samaritan Hospital, and Professor of Obstetrics and Gynecology, University of Cincinnati School of Medicine, Cincinnati, Ohio

Director of Urogynecology, Assistant Professor of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minn

Patients who want to be sexually active but suffer iatrogenic vaginal constriction or shortening, or both, are a surgical challenge. Their condition may require any of a variety of nonsurgical and surgical procedures to restore the ability to have gratifying sexual intercourse, and they may need considerable preoperative and postoperative counseling and management.