Post Operative Care for Neovagina Surgery
The procedure typically takes approximately 1-2 hours for the Doctors to complete and is done in an outpatient hospital or surgery center setting. Patients can go home on the day of surgery, however most will stay overnight in the outpatient center or recovery center. Vaginal packing is placed and usually is removed within 36-48 hours following the surgery. At this point, the patient is taught to either use dilators or her fingers to apply estrogen cream twice daily to ensure that the vagina is maintaining its length and width. Usually during the first couple of weeks, there will be a pink discharge with exam/dilation or a small amount of bleeding, which is normal. This process is typically not painful to the patient. Intercourse can start as soon as the pink discharge or bleeding stops with self-exam or dilator use, which sometimes can be as early as 2 weeks post-operatively. In most cases, vaginal dilation per se is NOT necessary. Dilators are used on a daily basis to ensure that the vagina is not scarring down at all, and maintaining its width and length, however the dilators are usually not needed to stretch, widen or lengthen the vagina (as is the case with other neovagina type procedures). Dr. Moore and Miklos’s staff of nurses and assistance are inherently involved in patient teaching both pre- and post-operatively to ensure the patient is comfortable with the process.
Most of our patients do travel to us from other states or countries; therefore once home, patients can follow-up with their gynecologist or primary care provider should any issues or concerns come up. Dr. Moore and Dr. Miklos are also available for a phone consultation with the patient’s gynecologist or primary care physician if needed.
As long as the patient is passing their dilator to the proper depth without any complications, then they do not need a follow-up exam until 6 weeks after surgery and all that is really needed is a quick check to make sure she has healed properly. If all is going well, Dr. Moore and Dr. Miklos do not necessarily need to see the patient back in Atlanta or Beverly Hills for follow-up; however, a patient can elect to come see them for a post-operative care check-up.
Within 6 to 8 weeks after surgery, as long as the patient is comfortable passing the appropriate dilator and there is no bleeding or spotting with the passage, then they can become sexually active .
Because of Drs. Moore and Miklos’ expertise in laparoscopic vaginal reconstruction and specifically in Laparoscopic Neovagina creation, doctors from all over the US send their patients with MRKH and/or vaginal shortening to them. This is a somewhat rare condition and there are very few centers in the US that take care of women with this problem and therefore most GYN surgeons and/or plastic surgeons have very little experience with this condition. Drs. Miklos and Moore’s laparoscopic center is known throughout the world for their cutting edge surgical expertise and successful results. Because of this, they do more of these type of surgeries than most any other center in the US and have gained a great deal of experience with the condition and the treatment options for patients with these conditions. Their center, the hospital and their staff understands that it is stressful to travel away from home for surgery and therefore address these needs specifically with helping with logistics of insurance, travel, lodging and nursing support while in Atlanta or Beverly Hills. Most patients will stay in Atlanta or Beverly Hills for approximately one week total (pre and post surgery) and the staff ensures that all needs of patient and family are addressed and taken care of.