# Vestibulectomy

> Mediated Wiki article. Canonical URL: https://mediated.wiki/source/Vestibulectomy
> Markdown URL: https://mediated.wiki/source/Vestibulectomy.md
> Source: https://en.wikipedia.org/wiki/Vestibulectomy
> Source revision: 1324382991
> License: Creative Commons Attribution-ShareAlike 4.0 International (https://creativecommons.org/licenses/by-sa/4.0/)

Gynecological surgical procedure

A **vestibulectomy** is a gynecological surgical procedure that can be used to treat [vulvar pain](/source/Vulvodynia), specifically in cases of provoked [vestibulodynia](/source/Vestibulodynia). [Vestibulodynia](/source/Vestibulodynia) (vulvar vestibulitis) is a chronic pain syndrome that is a subtype of localized [vulvodynia](/source/Vulvodynia)[1] where chronic pain and irritation is present in the [vulval vestibule](/source/Vulval_vestibule), which is near the entrance of the vagina.[2] Vestibulectomy may be partial or complete.[3]

Vulvar vestibulectomy is primarily supported as an intervention for people who suffer from provoked vestibulodynia, which causes sexual pain to women.[4] It is not indicated as appropriate for people living with generalized vulvar pain disorders and non-provoked vestibulodynia.[1]

Vestibulectomy is not considered a first-line treatment option for provoked vestibulodynia,[5] but it is considered an effective treatment for the long-run and has recorded high levels of satisfaction from the patients.[6] One review found that significant pain relief was reported by 79% of patients.[7]

## Procedure

The surgery takes place below the urinary meatus, down to the border of the perineal area and includes the fourchette. [Incisions](/source/Surgical_incision) are made on each side adjacent and parallel to the [labia minora](/source/Labia_minora). The structures removed are the [hymen](/source/Hymen), [mucous membrane](/source/Mucous_membrane), [Bartholin glands](/source/Bartholin_glands) ducts and minor vestibular glands. In some surgeries, the amount of tissue removed is not so extensive. [Vaginal mucosa](/source/Vaginal_mucosa) tissue remains attached and then is pulled downward to cover the area where tissue was removed. This surgery is also used to treat [lichen sclerosus](/source/Lichen_sclerosus).[8] "The complete surgery removes the entire lateral hymenal tissues to the lateral vestibular walls at Hart’s line, and involves removal of the entire posterior fourchette from the posterior hymenal remnants down to the perineum" which barring complications, enables the entire procedure to be over within an hour.[9]

The procedure involves minimal bleeding and is usually done under spinal or general anesthesia.[10] The amount of tissue removed during the surgery can vary with respect to the pain.

## Complications

Complications related to vestibulectomy include bleeding and infection. Long-term complications can be weakness of the anal muscles, cosmetic changes, development of a [Bartholin's cyst](/source/Bartholin's_cyst), or a decline in vaginal lubrication. Reports of satisfaction with the outcome of the surgical procedure can be as high as 90%.[11]

The procedure has been known to be unsuccessful in rare cases, where the pain remained constant even after surgery.[12] In such cases, alternative treatments like oral medicines or more surgeries may be considered, depending on the severity of the persisting pain.[13]

## Recovery

The recovery period is about 6–12 weeks, depending on the amount of vulvar tissues removed. Post-surgery, the patient might need further physical and possible mental therapy to avoid scarring and lead a regular sexual life.[12]

## Epidemiology

In a study done in 2006, it was discovered that 93% of patients who had undergone the surgery recommended it for vulvar pain. Only 11% of women continued to have issues in their sex lives post-surgery.[14]

## References

1. ^ [***a***](#cite_ref-:0_1-0) [***b***](#cite_ref-:0_1-1) Rosen, Natalie O.; Dawson, Samantha J.; Brooks, Melissa; Kellogg-Spadt, Susan (2019). "Treatment of Vulvodynia: Pharmacological and Non-Pharmacological Approaches". *Drugs*. **79** (5): 483–493. [doi](/source/Doi_(identifier)):[10.1007/s40265-019-01085-1](https://doi.org/10.1007%2Fs40265-019-01085-1). [ISSN](/source/ISSN_(identifier)) [1179-1950](https://search.worldcat.org/issn/1179-1950). [PMID](/source/PMID_(identifier)) [30847806](https://pubmed.ncbi.nlm.nih.gov/30847806). [S2CID](/source/S2CID_(identifier)) [73485304](https://api.semanticscholar.org/CorpusID:73485304).

1. **[^](#cite_ref-2)** ["Vulvodynia and vestibulodynia | Skin Support"](https://web.archive.org/web/20160630072333/http://skinsupport.org.uk/conditions-details/vulvodynia-and-vestibulodynia). *skinsupport.org.uk*. Archived from the original on June 30, 2016. Retrieved 2018-10-27.

1. **[^](#cite_ref-3)** ["Vulvar Vestibulitis - Austin Urogynecology"](https://web.archive.org/web/20181028033543/https://www.austinurogynecology.com/vulvar-vestibulitis/). *Austin Urogynecology*. 2015-02-10. Archived from [the original](https://www.austinurogynecology.com/vulvar-vestibulitis/) on 2018-10-28. Retrieved 2018-10-27.

1. **[^](#cite_ref-4)** Lavy, Yuval; Lev-Sagie, Ahinoam; Hamani, Yaron; Zacut, David; Ben-Chetrit, Avraham (2005-05-01). "Modified vulvar vestibulectomy: simple and effective surgery for the treatment of vulvar vestibulitis". *European Journal of Obstetrics, Gynecology, and Reproductive Biology*. **120** (1): 91–95. [doi](/source/Doi_(identifier)):[10.1016/j.ejogrb.2004.04.039](https://doi.org/10.1016%2Fj.ejogrb.2004.04.039). [ISSN](/source/ISSN_(identifier)) [0301-2115](https://search.worldcat.org/issn/0301-2115). [PMID](/source/PMID_(identifier)) [15866093](https://pubmed.ncbi.nlm.nih.gov/15866093).

1. **[^](#cite_ref-5)** Bautrant, Eric; Porta, Oriol; Murina, Filippo; Mühlrad, Hanna; Levêque, Christine; Riant, Thibaut; Ploteau, Stephane; Valancogne, Guy; Levesque, Amélie (2019-10-01). ["Provoked vulvar vestibulodynia: Epidemiology in Europe, physio-pathology, consensus for first-line treatment and evaluation of second-line treatments"](https://www.sciencedirect.com/science/article/pii/S2468784719302429). *Journal of Gynecology Obstetrics and Human Reproduction*. **48** (8): 685–688. [doi](/source/Doi_(identifier)):[10.1016/j.jogoh.2019.04.011](https://doi.org/10.1016%2Fj.jogoh.2019.04.011). [ISSN](/source/ISSN_(identifier)) [2468-7847](https://search.worldcat.org/issn/2468-7847). [PMID](/source/PMID_(identifier)) [31051298](https://pubmed.ncbi.nlm.nih.gov/31051298). [S2CID](/source/S2CID_(identifier)) [145024370](https://api.semanticscholar.org/CorpusID:145024370).

1. **[^](#cite_ref-6)** Eva, Lois J.; Narain, Sumana; Orakwue, C. Obi; Luesley, David M. (2008). "Is modified vestibulectomy for localized provoked vulvodynia an effective long-term treatment? A follow-up study". *The Journal of Reproductive Medicine*. **53** (6): 435–440. [ISSN](/source/ISSN_(identifier)) [0024-7758](https://search.worldcat.org/issn/0024-7758). [PMID](/source/PMID_(identifier)) [18664062](https://pubmed.ncbi.nlm.nih.gov/18664062).

1. **[^](#cite_ref-7)** Tommola, Päivi; Unkila-Kallio, Leila; Paavonen, Jorma (2010). "Surgical treatment of vulvar vestibulitis: a review". *Acta Obstetricia et Gynecologica Scandinavica*. **89** (11): 1385–1395. [doi](/source/Doi_(identifier)):[10.3109/00016349.2010.512071](https://doi.org/10.3109%2F00016349.2010.512071). [ISSN](/source/ISSN_(identifier)) [1600-0412](https://search.worldcat.org/issn/1600-0412). [PMID](/source/PMID_(identifier)) [20955094](https://pubmed.ncbi.nlm.nih.gov/20955094). [S2CID](/source/S2CID_(identifier)) [19466615](https://api.semanticscholar.org/CorpusID:19466615).

1. **[^](#cite_ref-8)** *Williams gynecology*. Barbara L. Hoffman, J. Whitridge Williams (2nd ed.). New York: McGraw-Hill Medical. 2012. p. 1070. [ISBN](/source/ISBN_(identifier)) [978-0-07-171672-7](https://en.wikipedia.org/wiki/Special:BookSources/978-0-07-171672-7). [OCLC](/source/OCLC_(identifier)) [779244257](https://search.worldcat.org/oclc/779244257).{{[cite book](https://en.wikipedia.org/wiki/Template:Cite_book)}}: CS1 maint: others ([link](https://en.wikipedia.org/wiki/Category:CS1_maint:_others))

1. **[^](#cite_ref-9)** ["Vestibulectomy | San Diego Sexual Medicine"](http://www.sandiegosexualmedicine.com/female-treatments/vestibulectomy). *www.sandiegosexualmedicine.com*. Retrieved 2018-10-27.

1. **[^](#cite_ref-10)** Haefner, Hope K.; Collins, Michael E.; Davis, Gordon D.; Edwards, Libby; Foster, David C.; Hartmann, Elizabeth (Dee) Heaton; Kaufman, Raymond H.; Lynch, Peter J.; Margesson, Lynette J.; Moyal-Barracco, Micheline; Piper, Claudia K. (2005). ["The Vulvodynia Guideline"](https://doi.org/10.1097%2F00128360-200501000-00009). *Journal of Lower Genital Tract Disease*. **9** (1): 40–51. [doi](/source/Doi_(identifier)):[10.1097/00128360-200501000-00009](https://doi.org/10.1097%2F00128360-200501000-00009). [ISSN](/source/ISSN_(identifier)) [1089-2591](https://search.worldcat.org/issn/1089-2591). [PMID](/source/PMID_(identifier)) [15870521](https://pubmed.ncbi.nlm.nih.gov/15870521). [S2CID](/source/S2CID_(identifier)) [18081230](https://api.semanticscholar.org/CorpusID:18081230).

1. **[^](#cite_ref-11)** Unger, C.A.; Kow, N.; Jelovsek, J. (2014). ["Vestibulectomy: A Review of Technique"](https://doi.org/10.1016/j.jmig.2013.12.077). *[Journal of Minimally Invasive Gynecology](/source/Journal_of_Minimally_Invasive_Gynecology)*. **21** (2): S45. [doi](/source/Doi_(identifier)):[10.1016/j.jmig.2013.12.077](https://doi.org/10.1016%2Fj.jmig.2013.12.077). [ISSN](/source/ISSN_(identifier)) [1553-4650](https://search.worldcat.org/issn/1553-4650).

1. ^ [***a***](#cite_ref-vulvalpainsociety.org_12-0) [***b***](#cite_ref-vulvalpainsociety.org_12-1) ["Surgery for vulval pain - Vulval Pain Society"](http://www.vulvalpainsociety.org/vps/index.php/treatments/surgery-for-vulval-pain). *Vulval Pain Society*. Retrieved 2018-10-27.

1. **[^](#cite_ref-13)** Ventolini, Gary (2011). ["Measuring Treatment Outcomes in Women With Vulvodynia"](https://web.archive.org/web/20170809162150/http://images.biomedsearch.com/21811531/jocmr-03-59.pdf?AWSAccessKeyId=AKIAIBOKHYOLP4MBMRGQ&Expires=1502409600&Signature=ZseYiGkvNY6AvXE%2Bfo%2BdRVluF%2Fk%3D) (PDF). *Journal of Clinical Medicine Research*. **3** (2): 59–64. [doi](/source/Doi_(identifier)):[10.4021/jocmr526w](https://doi.org/10.4021%2Fjocmr526w). [PMC](/source/PMC_(identifier)) [3140924](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3140924). [PMID](/source/PMID_(identifier)) [21811531](https://pubmed.ncbi.nlm.nih.gov/21811531). Archived from [the original](http://images.biomedsearch.com/21811531/jocmr-03-59.pdf?AWSAccessKeyId=AKIAIBOKHYOLP4MBMRGQ&Expires=1502409600&Signature=ZseYiGkvNY6AvXE%2Bfo%2BdRVluF%2Fk%3D) (PDF) on 2017-08-09.

1. **[^](#cite_ref-14)** Goldstein, Andrew T.; Klingman, Daisy; Christopher, Kurt; Johnson, Crista; Marinoff, Stanley C. (2006). "ORIGINAL RESEARCH—SURGERY: Surgical Treatment of Vulvar Vestibulitis Syndrome: Outcome Assessment Derived from a Postoperative Questionnaire". *The Journal of Sexual Medicine*. **3** (5): 923–931. [doi](/source/Doi_(identifier)):[10.1111/j.1743-6109.2006.00303.x](https://doi.org/10.1111%2Fj.1743-6109.2006.00303.x). [hdl](/source/Hdl_(identifier)):[2027.42/74334](https://hdl.handle.net/2027.42%2F74334). [PMID](/source/PMID_(identifier)) [16942537](https://pubmed.ncbi.nlm.nih.gov/16942537). [S2CID](/source/S2CID_(identifier)) [25781480](https://api.semanticscholar.org/CorpusID:25781480).

## External resources

Wikimedia Commons has media related to [Gynaecology](https://commons.wikimedia.org/wiki/Category:Gynaecology).

v t e Sexual and reproductive health Rights Reproductive justice Compulsory sterilization Contraceptive security Abortion-rights movements Genital integrity Circumcision controversy Intersex human rights Education Sex education Genetic counseling Pre-conception counseling Planning Childfreeness/childlessness Birth spacing Parenting adoption foster care Sperm theft Contraception Hormonal contraception Male contraception Safe sex Condom Intrauterine device Sterilization Assisted reproduction In vitro fertilization ICSI Gamete Cryopreservation Egg Sperm Sperm bank fertility fraud Health Men's Women's vulvovaginal Research self-report sexual risk behaviors Pregnancy Maternal health Obstetrics Unintended pregnancy childbirth Abortion Options counseling Pregnancy from rape Pregnant patients' rights Prenatal care Teenage pregnancy Precocious puberty and pregnancy Identity Gender identity Sexual orientation Intersex Transgender Genital modification Medicine Andrology Genitourinary medicine Gynaecology Obstetrics and gynaecology Reproductive endocrinology and infertility Sexual medicine Transgender health care Disorders Disorders of sex development Infertility Reproductive system disease Sexual dysfunction Sexually transmitted infections clinic Gender dysphoria By country China India Iran Ireland Pakistan Philippines Singapore United Kingdom teen United States teen pregnancy birth control History Birth control movement in the United States History of condoms Social hygiene movement Timeline of reproductive rights legislation Policy One-child policy Two-child policy Three-child policy Abortion law

v t e Tests and procedures involving the female reproductive system Gynecological surgery Ovaries Oophorectomy Salpingoophorectomy Fallopian tubes Falloposcopy Salpingectomy Tubal ligation Essure Tubal reversal Uterus General: Genitoplasty Hysterectomy Hysterotomy Pelvic exenteration Uterine artery embolization Transplantation Uterine cavity: Hysteroscopy Vacuum aspiration Endometrium: Endometrial biopsy Endometrial ablation Myometrium: Uterine myomectomy Cervix: Colposcopy Cervical conization LEEP Cervical cerclage Cervical screening (Pap test) Cervicectomy Pessary insertion Vagina Vaginectomy Culdoscopy Culdocentesis Episiotomy husband stitch Hymenotomy Colpocleisis Hymenorrhaphy Vaginal wet mount Vaginal transplantation Vulva Vulvectomy Female genital mutilation Labiaplasty Clitoral hood reduction Vestibulectomy Medical imaging Gynecologic ultrasonography Hysterosalpingography

v t e Tests and procedures on the skin and subcutaneous tissue Skin Escharotomy Suture Skin grafting Mohs surgery Free flap Rotation flap TRAM flap Electrodesiccation and curettage Cryosurgery Skin biopsy Excision Rhytidectomy Liposuction Z-plasty Medical imaging Wood's lamp Hair Hair transplantation

---
Adapted from the Wikipedia article [Vestibulectomy](https://en.wikipedia.org/wiki/Vestibulectomy) by Wikipedia contributors ([contributor history](https://en.wikipedia.org/wiki/Vestibulectomy?action=history)). Available under [Creative Commons Attribution-ShareAlike 4.0 International](https://creativecommons.org/licenses/by-sa/4.0/). Changes may have been made.