Plastic surgical postero-lateral redirection extension vulvo-vaginoplasty.

This paper offers a report of a vulvo-vaginoplasty, that rotates the vaginal axis away from alignment with the internal genitalia and bladder to treat refractory coitally connected recurrent cystitis and deep internal genital and bladder dyspareunia, by lessening coital trauma to the bladder and the internal genitalia. This rotation also aligns the vagina with the clitoris and the upper inner labia, which increases the mechanical efficiency of indirect coital clitoral manipulation via the inner labia and adds direct coital clitoral manipulation. The intensity of coital sexual response is thereby equated with the intensity of clitoral response. Standard reconstructive surgical procedures are utilized to rotate the axis of the vagina, which shorten the long axis of the vagina, requiring the concomitant construction from the labia majora of an extension of the vagina and a new introitus, both of an appropriate diameter. This extends the vagina to the clitoris and the indications for the operation to treatment of iatrogenic or congenital stricture and shortening of the vagina; and childbirth enlargement. The clitoris is not moved. It is circumcised to increase clitoral response. A preliminary report of results is included herein.