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What Is a Vaginal Incision?

By Synthia L. Rose
Updated Feb 13, 2024
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A vaginal incision is a surgical cut through the vulva and vaginal region, generally for performing a hysterectomy, episiotomy or a corrective operation to restore prolapse of the uterus, bladder or vaginal canal. During surgeries involving a vaginal incision, tissue between the anus and vagina are spliced open while the patient is under anesthesia. At that point, the doctor is able to access the inner pelvic region for the purpose of adjusting or removing a baby, fibroids, a diseased uterus or a bladder.

Surgeons can perform two types of vaginal incisions. The medio-lateral vaginal incision vertically traverses the area between the vagina and buttocks for a few inches before jutting diagonally to the flesh near the top inner thigh. By cutting on an angle, this incision avoids coming too close to the anus and causing an anal tear. Since this cut is not straight, it can be complex for surgeons to mend. Healing is extensive and often more than six weeks for this style of vaginal incision.

The median incision is a more common vaginal incision. It is a complete straight cut that severs the perineum and stops right before reaching the anus. While a median vaginal incision is much easier to stitch up after surgery, this incision carries a higher risk for anal tears and more damage.

Either of these incisions may be used during childbirth when the baby being delivered is forcing his way through the vaginal canal before the woman is fully dilated or when the baby’s head and body are so abnormally large that they would tear the woman’s vagina if an incision were not made. During a vaginal hysterectomy, these incisions allow a doctor to remove the uterus, ovaries or both by pulling them through the vaginal canal. Vaginal incisions in this case help a physician to avoid cutting into a woman’s abdomen. In some cases, however, a doctor may elect to perform a laparoscopic hysterectomy, which uses tiny abdominal cuts along with a full vaginal incision.

When organs inside the pelvic region shift, fall or jut forward due to internal trauma, a vaginal incision allows a surgeon to relocate the organs with minimal invasion. This prolapse of organs sometimes requires doctors to insert artificial materials through the vagina to anchor the organs in place. Surgeries involving vaginal incisions for any of these three emergencies may require hospital stays ranging from two days to a week.

Full recovery from a vaginal incision may take one or two months and require women to avoid getting the vaginal area wet that entire time. Bleeding is often possible for days after an incision, requiring women to wear cotton pads. Risks during recovery from a vaginal incision include the development of scar tissue and improper alignment of the stitched flesh. After recovery, sex may be painful.

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