New frontiers in pelvic floor surgery: avoiding and managing the iatrogenically induced foreshortened, constricted, or painful vagina

Excerpt

Historically, vaginal surgery resulting in vaginal stenosis, significant pain, vaginal shortening, or vaginal constriction has been a relatively rare finding, mostly occurring in patients who have received radiation for treatment of gynecologic malignancy or who have undergone overzealous correction of pelvic organ prolapse, including aggressive levatorplasty at the end of a posterior colporrhaphy. One of the authors (M.M.K.) initially published a small series on surgical management of iatrogenic vaginal constriction in 2003 [1]. This 5-year review involved 20 women, an average of four patients per year, seen at this specific referral center. The authors of this article have noted a dramatic increase in the number of patients presenting with these complications over the past 2 years, with an estimated incidence of eight to ten patients per month at each of their referral centers. …