Definition and Overview

A hymenorrhaphy is a surgical procedure that aims to repair the hymen by stitching it back together.

Also known as hymen reconstruction, it is not considered a part of conventional gynecological care and is often classified as a plastic surgery procedure, mainly due to its lack of a medical purpose. It is therefore not widely available in hospitals, so patients need to go to private clinics to have the procedure done.

Women who undergo the procedure usually do so to cause the hymen to bleed when broken through during sexual intercourse, which some cultures consider to be a proof of virginity. However, the procedure is considered taboo in some cultures and is even illegal in certain countries.

Who Should Undergo and Expected Results

Women who want to restore the original structure of their hymen, the thin membrane that covers the vaginal opening, could consider a hymenorrhaphy. Also known as a virgin’s veil, the hymen typically breaks during sexual penetration. However, it can also be lacerated by other factors, such as injury, sports, physical exercise, masturbation, use of tampons, or disease. On the other hand, some women’s hymens are more elastic that even penetration itself does not cause it to tear. Thus, a lacerated hymen and the lack of bleeding during sexual intercourse do not necessarily mean that a woman is not a virgin.

Below are the most common reasons of women undergoing a hymenorrhaphy:

  • To serve as a sign of virginity prior to an intended marriage, which is required in some cultures
  • To help with healing in the cases of women who suffered from sexual assault – This procedure may provide emotional or psychological relief for the victim.
  • To repair a hymen that is torn due to injury
    Women who are considering having a hymenorrhaphy to restore their virginity have to consider the recovery period after the surgery when scheduling the procedure. They are typically advised to undergo the procedure between three weeks and three months prior to getting married.

How Does the Procedure Work?

A hymenorrhaphy is a simple, non-invasive procedure that can be performed under local anaesthesia combined with mild sedation. However, if certain circumstances surrounding the patient’s condition calls for it, the procedure can also be performed under general anaesthesia.

In preparation for the hymen reconstruction, the surgery begins with the excision of the torn edges of the hymen.

There are three ways in which a hymen reconstruction is performed:

  • Sewing together the torn skin that makes up the secondary layer of the hymen to make the hymen look intact
  • Placing an artificial membrane without blood supply to serve as an artificial hymen, with the option of placing a gelatin capsule containing an artificial substance that looks like blood
  • Placing a flap taken from the lining of the vagina to create a new fully functional hymen complete with blood supply that serves as a completely restored hymen
    For patients who undergo the second type of hymenorrhaphy, it is necessary to refrain from having penetrative sexual intercourse for three months leading up to the procedure.

In a hymenorrhaphy, surgeons typically use dissolvable sutures, which means there is no need for the patient to go back to the doctor to have the sutures removed.

Possible Risks and Complications

While generally safe, a hymenorrhaphy carries some degree of risk just like any other surgery. These include:

  • Infection – Infection is a common risk that is present in any kind of surgery. This is why in most, if not all, cases, the attending physician prescribes antibiotics to prevent the onset of infection.
  • Bleeding – While bleeding is normal after the procedure, it should subside and go away completely within a few days. Prolonged bleeding may be a sign of a possible complication.
  • Stricture – This occurs when the hymen is over-corrected, and the membrane, which used to be elastic, becomes too tight, causing the opening to become too narrow. This may cause some pain during sexual intercourse, but may resolve without treatment.

Despite the small risk it carries, complications following a hymen reconstruction procedure are very rare.

References:

  • Ahmadi A. Ethical issues in hymenoplasty: Views from Tehran's physicians. J Med Ethics.2014;40:429–30

  • Goodman MP. Female cosmetic genital surgery. Obstet Gynecol. 2009;113:154–9.

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