Synonyms: Hymenoplasty, hymen reconstruction surgery, hymenorrhaphy, hymen surgery, revirgination operation, hymen repair surgery, hymen rejuvenation etc are different terms used in hymen related operations.
What is hymen: The hymen is the mucous membrane that partially closes the entrance to the vagina, named after the god of marriage in classical Greek mythology, Hymenaios. It is a thin membranous rim of tissue which encircles the vaginal orifice and has an opening in the centre for menstrual discharge.
Promoting the concept of intact hymen as a sign of virginity is nothing but perpetuation of myth.
Preoperative preparation: A preoperative consultation and examination is required to discuss and evaluate the patient’s needs and expectations. Local infection if any will require prior treatment. Patients are counselled about various options, the surgical procedure, possible risks and postoperative care.
Postoperative care: The patient can return home after the procedure. Patients are advised to wear a pad, similar to a sanitary pad for 2 – 3 days postoperatively. Irrigation of wound with normal saline is advised 2-3 times daily for 5-7 days. Patients are prescribed analgesics and antibiotics for about 7-10 days. Swelling may be noticeable after the first day and will slowly subside over a period of 2 weeks. Sexual intercourse and strenuous activities like horse riding and sports should be avoided for at least 4-6 weeks. Patients should also avoid douching and tampons for 4- 6 weeks.
What is hymen: The hymen is the mucous membrane that partially closes the entrance to the vagina, named after the god of marriage in classical Greek mythology, Hymenaios. It is a thin membranous rim of tissue which encircles the vaginal orifice and has an opening in the centre for menstrual discharge.
Myths
about intact hymen
Unfortunately, in some cultures,
an intact hymen is held as a sign of virginity and has become symbolic of
family honour. Blood stained bed-sheets are expected on nuptial nights and they
are vibrantly portrayed in society to represent bleeding from ruptured hymen on
defloration. Deviation from this religious conviction has harmful repercussion
on the woman which ranges from shame to ‘honour killing.’ Young women sometimes
go to great lengths to get their hymen repaired.
Medical
facts about hymen
According to the available medical literature the
hymen serves no known biological function in adults. The available medical literature
says that repair of hymen has no direct medical benefits. Various other known
facts are:
•
Rupture of hymen is of no medical consequence. The absence
of hymen and bleeding on first night is not a sign of lost virginity.
•
Hymen was intact in as many as 52% of adolescent
girls who admitted to have had sexual intercourse.
•
The hymen is a relatively bloodless membrane and it
is unlikely to bleed significantly even if it is torn. Violent penile
penetration results in laceration of the vaginal wall, that appears to be
responsible for ‘‘blood-stained bedsheets.’’
•
The
hymen may not be lacerated even with repeated coitus (wide or elastic hymen).
•
In
fact, many cases of pregnancy have been reported in women in whom the hymen has
not have been ruptured.
•
Some
women are even born without a hymen
Promoting the concept of intact hymen as a sign of virginity is nothing but perpetuation of myth.
Social
and legal aspects of hymen repair:
In many cultures like Muslim and Norwegian ethnic
background the chastity of the woman before marriage a key requirement. If
not proven to be virgin, she may be ostracized, humiliated and sometimes
killed.
The status of hymenoplasty in different parts of the
world is controversial and debatable. It is illegal in most Arab countries. In United States of America, the western
society and in India hymenoplasty is legal.
Operative reconstruction of the hymen is a
relatively simple procedure. The surgical repair of hymen in most cases
solves the problem for these unhappy women and sometimes save lives. It is thus
definitely acceptable in certain circumstances, when the woman would otherwise
suffer shame, dishonour and humiliation.
Why would somebody
seek reconstruction of torn hymen?
Hymen repair surgery is undertaken
to tighten and restore the hymen to a more intact, virgin-like state. It is usually
demanded for cultural or other personal reasons (for example before marriage).
Women who desire to restore an intact, tight hymen ring and experience vaginal
bleeding and pain with the "first" sexual intercourse usually go for
hymenoplasty. Various reasons for which Hymenoplasty is sought are:
- Hymen injury: Hymen tear may be caused by sexual intercourse, sports
activities, rigorous physical exercise, masturbation, surgical injury,
bicycling, gymnastics and horse riding or dancing. Hymen may rupture even
by the use of tampon.
- Cultural
or religious reasons: In some cultures, a woman
is physically inspected to assure an intact hymen to confirm her
virginity.
- After
rape, incest, and sexual abuse: Some women view
this as a way to restore their physical and psychological integrity.
- For
Revirginization: Women who want to give their
partner a unique gift.
What
is Hymenoplasty?
Hymenoplasty is
the surgical restoration of the hymen.
The term
Hymenoplasty is generally used for:
(1) Repair of a tear in the hymen.
(2) Restoration of a hymen ring which has been mutilated due to multiple
sexual intercourse.
(3) Reconstruction of a new hymen membrane using a flap of vaginal
mucosa.
Hymen repair is performed
under local anaesthesia as an OPD procedure. It may take about 1 – 2 hours. The
torn edges of remnant hymen are trimmed and stitched with fine absorbable
sutures. A patch of local vaginal tissue may be used to reconstruct the hymen. The
hymenoplasty procedure is surgically tailoring the hymenal remnants so that
they can be sutured together with absorbable sutures to narrow the vaginal
orifice. Hymen repair is done leaving a narrow orifice in the centre, so that menstrual blood may come out.
Sometimes a gelatine capsule filled with artificial blood like substance is incorporated
in the repaired hymen. During subsequent sexual intercourse the repaired hymen
is torn and the gelatine capsule ruptures resulting in typical pain and bleeding
as desired for cultural reasons. The procedure can be repeated as many times as
desired.
When should Hymenoplasty be done?
The
procedure can be done any time after the hymen has ruptured. It is preferable
to fix the surgery few days after the menstrual period is over and about a
month before marriage.
Preoperative preparation: A preoperative consultation and examination is required to discuss and evaluate the patient’s needs and expectations. Local infection if any will require prior treatment. Patients are counselled about various options, the surgical procedure, possible risks and postoperative care.
Postoperative care: The patient can return home after the procedure. Patients are advised to wear a pad, similar to a sanitary pad for 2 – 3 days postoperatively. Irrigation of wound with normal saline is advised 2-3 times daily for 5-7 days. Patients are prescribed analgesics and antibiotics for about 7-10 days. Swelling may be noticeable after the first day and will slowly subside over a period of 2 weeks. Sexual intercourse and strenuous activities like horse riding and sports should be avoided for at least 4-6 weeks. Patients should also avoid douching and tampons for 4- 6 weeks.
Complications: Hymenoplasty is a relatively safe surgery. Some patients may get
postoperative bleeding for a few days. Local infections may require antibiotics
for 1-2 weeks. Stricture occurs very rarely due to overcorrection. Patients
should come for a follow up if required.
In conclusion, Hymen repair is ethically and culturally controversial,
but is seen as an acceptable surgery in many countries.
