Vaginal shortening can occur after any gynecologic surgery. When shortening occurs, it can be one of the most difficult complications to correct. Procedures that could cause vaginal shortening include: Hysterectomy, vaginal prolapse repair, bladder suspension surgery, bladder tack, anterior repair, posterior repair, enterocele repair, vaginal mesh surgery, sacrospinous ligament suspension, and vault suspension. This can also occur after cervical or uterine cancer surgery and radiation therapy.

There are many treatments for a shortened vagina, both surgical and nonsurgical. Some of the nonsurgical techniques include:

  • Pelvic floor physical therapy
  • Pelvic floor massages.
  • Vaginal dilators

There are many invasive procedures utilizing skin grafts, biologic animal grafts, or even bowel to lengthen the vagina, however, these techniques can be unnecessarily invasive with possible higher complication rates, especially when compared to the technique Doctor Miklos and Doctor Moore utilize.

This technique used by the doctors is the laparoscopic neovagina. Before this invention came to light, the Davydov Procedure was the best one available. Even to this day, it is routinely used to create canals in young women that are born without a vagina. However, Doctor Miklos and Doctor Moore were two of the first surgeons in the world to successfully utilize this procedure to lengthen surgically shortened vaginas.

The doctors have been performing the laparoscopic Davydov procedure since 1999.

Miklos and Moore have been able to modify the Davydov procedure to create vaginal length in patients with shortened vaginas. It is the least invasive technique, with minimal complications and gives the greatest chance of vaginal lengthening success. The patient’s own internal issue (such as the peritoneum, which is the lining of the pelvis) is mobilized and utilized to lengthen the vagina, therefore no external grafts are necessary and the risk of scarring down is minimized. The doctors have helped women with shortened vaginas after cervical cancer and radiation therapy. Patients who have undergone radiation therapy often have severe scarring, which is considered one of the most complicated types of patients to lengthen a vagina, however, they have been used the procedure successfully.

Doctor Miklos and Doctor Moore have successfully restored vaginal length in women who have failed other surgical lengthening procedures. They have successfully utilized the laparoscopic Davydov technique on patients who have already and failed: McIndoe, Vecchietti, and Gracilis flap procedures, or other vaginal lengthening procedures, including attempts at lengthening with dermal grafts.

During the procedure, the shortened vagina is opened and the peritoneum from the pelvis is advanced down to the opening to create the lining of the new vaginal wall.

A study done by Doctors Miklos and Doctor Moore involves a 62-year-old patient who has undergone multiple vaginal surgeries with symptoms suggestive of cystocele, rectocele, vaginal vault prolapse, and dyspareunia. Excessive vaginal shortening and a painful vaginal apex were also noted upon initial examination.

After the procedure was over, the doctors were able to have a discussion about it. Vaginal shortening can be an unfortunate complication of vaginal surgery, especially with those procedures used to correct pelvic organ prolapse, including hysterectomy and anterior, posterior, and enterocele repairs. This result can be devastating, especially for sexually active patients, as shortening may result in despair and, if severe, inability to have intercourse altogether. These patients are left with few options for length restoration.

The laparoscopic Davydov is an established technique for neovagina creation in patients with MRKH. The procedure involves using the patient’s own pelvic peritoneum to create the vaginal canal and apex. One study demonstrated the presence of stratified squamous epithelium, similar to that found at the vaginal introitis, lining the entire surface of the peritoneal tissue used for the neovagina in as little as 90 days post-op.

As a result, this patient has reported that the increase in vaginal length was about three inches. Additionally, the patient was able to resume intercourse, and reported no dyspareunia after the operation.

From this, it is clear that this new procedure will represent a new option for patients looking for an iatrogenic vaginal shortening.

Schedule an in person or telephone consult with Drs. Miklos and Moore to discuss Vaginal lengthening surgery.