Objective: To investigate the surgical procedures and outcomes of repairing the wound in the posterior wall of vaginal orifice by labium minus flap transfer, when vagina tightening plastic surgery is performed on the patient with scar in the posterior wall of vaginal orifice and labium minus hypertrophy.
Methods: From May 2007 to May 2008, 10 patients suffering from postpartum vaginal relaxation combined with scar in the posterior wall of vaginal orifice and labium minus hypertrophy were treated. The patients aged 28-40 years old and the width of their labium minus was 3-5 cm. Six of them had coitus pain. Vaginal tightening surgery was performed, meanwhile the hypertrophic labium minus was prepared into the anterior-pedicle labium minus flap (4 cm x 1 cm - 5 cm x 1 cm) and the posterior-pedicle labium minus flap (3 cm x 2 cm - 4 cm x 3 cm), respectively. The posterior-pedicle labium minus flap was transferred inwards by 90 degrees to repair the wound caused by the resection of the scar, and the anterior-pedicle labium minus flap was sutured in situ to form the new labium minus.
Results: All the posterior-pedicle labium minus flaps survived, except for 3 cases in which the epidermis 1 cm around the distal end of posterior-pedicle labium minus flap was exfoliated and recovered 2 weeks after hip bath with potassium permanganate solution (1:5000). All the anterior-pedicle labium minus flaps survived, and all the incisions healed by first intention. Over the follow-up period of 2-8 months, all the patients were satisfied with their vulva configuration, good elasticity of vaginal orifice and no tenderness pain of vaginal orifice. The sensitivities to feeling, such as touch and pain, of the transferred labium minus flap were similar to the normal labium minus. Postoperatively, the coitus pain disappeared, 7 cases had much better sex life and 3 cases had no significant improvement in sex life.
Conclusion: Transferring labium minus flap to vaginal orifice is an effective way to improve the coital pain resulted from the scar of vaginal orifice.