The incidence of vaginal laxity is high and the treatment rate is low. Plastic surgery, radiofrequency therapy, laser therapy and box floor muscle rehabilitation are the commonly used treatments at this stage. Among them, radiofrequency treatment, which has been proven safe and effective in multicenter randomized controlled studies, has rapidly developed into a promising treatment method, and vaginal tightening, which preserves the vaginal mucosa, is widely used in plastic surgery. VaginalLaxitysyndrome (VLS) is an early symptom of female pelvic floor dysfunction (PFD) [1], which has recently attracted increasing attention. In an international study in 2021: 83% of 563 women had symptoms of vaginal laxity but did not seek medical attention, which seriously affects sexual function and intimacy, leading to a reduction in vaginal mucosal folds, decreased patient sexual satisfaction and sexual dysfunction, accompanied by pelvic floor organ prolapse and stress urinary incontinence, which can cause inconvenience in normal life 1. Pathogenesis and etiology VLS is the result of the combined action of a variety of pathogenic factors. The metabolic abnormality and remodeling of the extracellular matrix (ECM) of connective tissues are the basis of its pathogenesis and important molecular pathological features, and the content and function of collagen and elastin in the ECM determine the supportive function of the pelvic floor organs and tissues; potential risk factors such as pelvic floor mechanical injuries, oxidative stress, and the withdrawal of estrogen levels, which may be caused by a wide range of signaling pathways and multiple targets, were found to be involved in the pathogenesis of VLS. 11 Studies on 324 women found that VLS is caused by a variety of pathogenic factors. A study of 324 women found that the prevalence of VLS was 24%, and the severity of symptoms was almost proportional to the degree of uterine prolapse, so vaginal laxity is likely to be a symptom of abdominal organ prolapse. 2. Evaluation of the condition and outcome of VLS Evaluation of the degree of vaginal laxity (1): Vaginahealthindexscore (VHIS) was used to evaluate the degree of vulvar laxity. [2] (2) Patients’ subjective perception of vaginal laxity was categorized into 7 degrees: very loose, moderately loose, slightly loose, not loose but not tight, slightly tight, moderately tight, and very tight. (3) Objective indicators: vaginal tactile imaging: the pressure sensor is placed into the vaginal cavity according to the Showa standard, and the pressure data of the whole vagina is measured in 360 degrees to evaluate the biomechanics of the soft tissues of each wall of the vagina, and accurately locate the specific area of the vaginal wall laxity, i.e., the VTI can show the decrease of the pressure gradient in some areas of the vaginal wall during the measurement. (4) Pelvic floor electrophysiological index: the neuromuscular stimulation therapy device is inserted 2cm into the vaginal opening to measure the muscle strength of the box floor muscles, the degree of muscle disease and vaginal pressure. 3.Treatment of VLS Plastic Surgery: Surgical treatment can remodel the muscles and vaginal mucosal folds to a greater extent, and strengthen the vaginal wall and its surrounding supportive tissues and structures. First, the principle of treatment: 1, in the neighboring rectum, urethra without damage to the premise of narrowing the internal diameter of the vaginal cavity and narrowing the vaginal opening 2, to improve the patient and sexual partner sexual satisfaction. (1) Indications: 1. Decreased sexual satisfaction due to VLS. Vaginal cleft. Vaginal opening laxity. Contraindications: 1, Uterine prolapse. 2, Vaginal tumor. 3, Acute inflammation of genitals, inflammatory vaginal diseases, cervical inflammation. 4, Sexually transmitted diseases. Relative contraindications: 1, infertile women with reproductive desire. 2, Poorly controlled hypertension. 3, Women after cesarean section. (4) Preoperative assessment: history taking, physical examination, psychosocial assessment, assessment of vaginal laxity, assessment of sexual function. It should be noted that although vaginal tightening can repair the vaginal support structure to improve sexual function. Second, the preoperative preparation: 1, avoid menstruation, adultery, 3 ~ 7d after menstruation is the best:2 3d before the operation every day based on the volts rinse vulva and vagina, 3d before the operation of oral metronidazole tablets, 3d before the operation of the prohibition of sexual intercourse, the night before the operation and the day of the operation of the day of the morning of the soapy enema in case of intestinal injuries caused by severe contamination. Postoperative treatment:1 vaginal filling cold based volatile gauze pressure on the blood 2, intravenous antibiotics for 3-5d to prevent infection 3, about 7d postoperative removal of stitches, buried treatment without folding 4, 2 months after the operation prohibit sexual life 5, prevent constipation, avoid intra-abdominal hypertension 6, 2-3 months after the operation to reduce vulvar friction. Complications:1 infection, vaginal erosion:2 hematoma:3 vaginal rectal impotence 4 postoperative painful intercourse 5 infertility, etc. Third, briefly describe the surgical methods. 1, buried wire: buried wire method is less traumatic, short time, a molding, is commonly used minimally invasive surgical methods. Embedded wire method mainly has the vaginal wall buried guide needle suture method, bilateral side wall buried wire augmentation method, etc. The vaginal wall buried guide needle suture method: from the vaginal opening of 5cm, 5 points of the mucosa to make about 2mm incision, with buried guide needle through 2-0 absorbable thread from this needle, in the superficial muscle layer of the vaginal wall along the long axis to the vaginal depth of about 7cm after dry 2 points out of the needle: the needle hole counterclockwise at the level of the 10 points out of the needle, then from this again into the needle, along the vagina, the superficial muscular layer along the long axis to the depth of about 7cm after drying 2 points out of the needle: this needle hole in the horizontal 10 points out of the needle, and then this needle hole counterclockwise, and then this needle. Then from this again into the needle, along the long axis of the vagina in the vaginal opening at 7 points out of the needle: and then from this into the needle, 5 points out of the needle, the suture will be led out of the incision, pulling the ends of the suture, to make sure that there is no damage to the rectourethral urethra, in the incision of a small opening outside the tightening of the knot, the thread knot buried under the dry membrane: in the distance from the vaginal opening of the vaginal opening of the same way tightening of the outer opening of the vagina, so that the outer opening to accommodate the 2 transverse fingers or less The method should be used in patients with mild and moderate vaginal laxity, but the results are good for patients with severe VLS. This method should be used for patients with mild to moderate vaginal laxity, but the effect is not good for patients with severe VLS. 2, bilateral side wall buried line augmentation method of vaginal tightening: in the vagina of both sides of the wall submucosal muscle layer interrupted suture 3 stitches, so that the vaginal mucosa and the muscle layer tightened to the cavity to form a bulge, reduce the volume of the vaginal cavity, the risk of damage to the rectum is small, due to the back wall of the vagina than the front wall of the distribution of nerves is more, and the G-point is located in the vaginal wall of the front of the upper end of the side wall of the buried line of the destruction of the sensation of sexual than the lower wall of the buried line is smaller. Larger wiring methods have been less frequently reported in recent years. [3] Vaginal stitches are used in different ways, but in general, they are more effective than traditional posterior vaginal mucosal resection alone. The duration of stitches may depend on the type of stitches, the site of stitches, suture absorption and breakage, the skill of the surgeon, and the quality of care in the early postoperative period, and a better procedure is still to be explored. Combination with other non-surgical therapies is more effective.