Patients complain of three problems when it comes to the vaginal opening (introitis). The first problem is a cosmetic issue – the vaginal opening looks to large or feels large. When the patient is questioned as to when this condition began the most common answer is since giving birth. The second problem is the vaginal opening is too small or the patient complains of pain with intercourse/sex. When the patient is questioned as to when the problem began the most common answer is after the delivery of my last child. Usually she will describe having a tear and repair or an episiotomy. On exam the surgeon can usually reproduce the pain that she feels during intercourse. This usually means the patient has excess scar tissue at the opening. The third problem is a patient will complain of less friction during intercourse and often will ask about making her vaginal opening smaller so she can feel more during intercourse. The patient needs to be told that fixing the just opening of her vagina will not enhance friction with intercourse. She should consider surgical repair of the internal vagina as well as the opening. This technique is called vaginal rejuvenation.

LEARN MORE ABOUT VAGINAL REJUVENATION

TREATMENT

The operation to fix both a small vaginal opening and a large vaginal opening are both called a perineoplasty. The term perineum is the area between the opening of the anus and vagina. The term plasty means surgery and does not necessarily mean making it specifically larger or smaller.

If a patient has an enlarged vaginal opening the perineum must be reconstructed to build up its integrity. When this is done it will narrow the opening of the vagina. See the surgery below

INSURANCE COVERAGE FOR ENLARGED VAGINAL OPENING TREATMENT

Coverage for Enlarged Vaginal Opening Treatment

If you have UMR insurance, coverage may be available when treatment for an enlarged vaginal opening is performed to correct a medically necessary pelvic floor issue rather than for cosmetic reasons alone. An enlarged vaginal opening can be associated with symptoms of pelvic floor laxity or connective tissue weakening that lead to discomfort, functional impairment, or hygiene concerns. When these symptoms are linked to an underlying pelvic floor condition — such as vaginal laxity related to prolapse, childbirth trauma, or connective tissue dysfunction — many UMR plans include benefits for the functional reconstructive portion of the surgery.

Our experienced Atlanta surgeons work directly with UMR insurance to verify your plan benefits, secure any required authorizations, and clearly explain what aspects of treatment may be covered versus self-pay before your procedure. If cosmetic components are elected that are not medically indicated, we’ll ensure you have a clear breakdown of what your plan may cover and what your out-of-pocket costs will be.