Case study of two patients with failed hymenoplasty

       Hymenoplasty is somewhat intimate, so many private hospitals tend to take advantage of this psychology of the seeker and operate haphazardly resulting in failure of hymenoplasty, which affects marital happiness but also dare not make a scene.  The hymen, because of its own anatomical and histological characteristics, lacks nerve fibers, has a poor blood supply, has no glandular and muscular components, and is composed mainly of elastic and gelatinous connective tissue, so the healing ability of the hymen is poor, and some patients may experience poor healing after the repair surgery, resulting in failure. Ask the patient to visit the hospital for regular post-operative review and tell the patient the final result of the surgery truthfully. Avoid any possible harm to the patient as a result of a failed surgery. This is the duty of a gynecologic cosmetic surgeon and the professional ethics that a gynecologic cosmetic surgeon has to abide by. Otherwise, it will cause irreparable harm to the patient. Patient female, 26 years old, because of old hymen rupture, in May 2003 in a beauty salon to accept the “hymen repair”, three months after the operation married, the wedding night without bleeding sex and lead to marriage rupture. After the specialist’s examination, it was found that the patient had an old fissure deep to the vaginal wall at 4° and 8° of the hymen, and the edge of the fissure was healed in the shape of teeth. Since the hymenoplasty surgeon did not ask the patient to come to the hospital for a review and tell her the final result of the surgery. As a result, the patient is unaware of the failure of the surgery and it leads to marital tragedy.  Medical developments have not yet solved the problem of hymen regeneration and reconstruction, however, some doctors have devised “hymen reconstruction” at the cost of disrupting the local anatomy.  The patient, a 24-year-old woman, underwent “hymen reconstruction” in 2001 at a beauty salon due to old hymen rupture, after which she experienced pain and bleeding during intercourse and was unable to have a normal sex life. The patient’s marriage was in crisis and the patient’s spirit was close to collapse. The patient’s vaginal opening was narrow and could only accommodate two fingers, the vaginal speculum was difficult to enter, the navicular fossa disappeared and was higher than the hymenal ring, the surgical scar was visible locally, only 10°-12° and 12°-2° of the hymen remained, the rest of the hymen was missing, and the mucous membrane of the posterior wall of the vaginal opening had a lamellar erosion surface. The surgery removed most of the patient’s hymen, while the outer navicular fossa of the hymenal ring was cut and sutured above the hymenal ring to form the so-called “hymen reconstruction”, resulting in narrowing of the vaginal opening after the surgery and damaged mucous membrane friction at the navicular fossa above the hymenal ring during intercourse, leading to painful intercourse and bleeding during intercourse. Since the surgery disrupts the normal anatomy and extension of the vaginal opening, it increases the chance of perineal lacerations if the patient has a vaginal delivery later.  Finally, remember that if you need to have hymen repair surgery you must find a professional doctor in a public tertiary care hospital and not listen to the one-sided words of private hospitals for life.