The Procedure


  • On the day of the appointment, you are going to meet Dr. Vitasna for discussion. She will explain the procedure. Consent forms and post-operative care instructions will be discussed and questions will be answered and clarified.
  • You may be asked about your expectations on the treatment.
  • Drug allergies and any condition that wouldn’t make you a good candidate for the procedure will be evaluated.
  • In case of uncertainty, doubt and worry, it is better to postpone the procedure.
  • Refrain from drinking beverages and eating food at least 6 hours prior to the surgery to avoid the risk of aspiration during or after the procedure.


  • The procedure is performed in our Operating Room for approximately 1 hour under Intravenous (IV) sedation or general anesthesia by our board-certified anesthesiologist.
  • During the surgery, Dr. Vitasna will remove the excessive vaginal wall tissues protruding into the vagina. Thus, the posterior vaginal wall tissues are separated forming a wedge shape or an inverted V shape as Figure 2.
  • Dr. Vitasna will suture both of the wound edges or two adjacent sides of the V shaped incision with slowly absorbable suture beginning with the cervical side (Figure2). She will do the suturing and tightening along the entire length of the posterior vaginal wall (see illustration). The suturing is done alternatively with 2 or 3 layers to avoid the post-operative bleeding.


  • You will be monitored in the recovery room for 1 hour. When you are conscious with normal vital signs, the anesthesiologist will allow you to be monitored in the In-patient Building.
  • Nausea and vomiting may be experienced , as a side effect of the spinal anesthesia or the general anesthesia, but which is noted to be relieved as soon as its effect wears off.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            
  • In the In-patient Building, you will take antibiotics, anti-inflammatory and analgesics will be given to relieve the pain. Laxatives will also be given to prevent constipation. If you will find no relief, the nurse may administer an injection.
  • Urinary frequency or difficulty in urination may be noted due to the tension of the peri-vaginal opening muscle. A Foley catheter may be inserted to avoid the retention of urine which may cause cystitis especially in the first two days after the procedure. When the tension is relieved, the catheter will be removed.
  • Within two days after the procedure, taking a shower is not advised. You may take a shower after the catheter is removed.

1-2 days after the surgery

Dr. Vitasna will allow you to return home after the following things are checked:

  1. No active bleeding on the surgical site.
  2. Post-operative care is reviewed.
  3. Be able to urinate after the Foley catheter is removed.

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