Objective: To present a comprehensive review of reported experience with the management of iatrogenic vaginal constriction. The authors also summarize available outcome data and compare these results with their own experience in managing this complication.
Methods: A thorough search of Medline for all papers referenced by the key words “vaginal stenosis,” “vaginal constriction,” and “complications of vaginal surgery” was undertaken. Papers concerning the management of postoperative vaginal constriction and the references cited therein were reviewed. The various surgical techniques used in the management of this complication were then summarized. Techniques reviewed include incision of vaginal constriction ring/ridge, vaginal advancement flap, Z-plasty, full-thickness skin graft, labial cutaneous flap, midline perineotomy, and bilateral episiotomy. The authors also report their own experience with four of these techniques.
Results: The anatomic cure rate using such operations to treat iatrogenic vaginal constriction is 57% to 100%. The resolution of dyspareunia, or functional cure rate, is 50% to 100%.
Conclusions: The procedures described herein can successfully treat the complication of postoperative vaginal stenosis.