Hymen repair

HYMENOPLASTIA

General information about the hymen

The Latin name of the hymen is HYMEN. The name hymen comes from ancient Greek. In Greek mythology, the name of the god of marriage is Hymen (himen). In ancient Greece, the hymen was called hymen because the wedding night was dedicated to the god of marriage. The middle of the hymen is perforated and allows passage to cervicovaginal secretions and menstrual blood. It is usually named according to the shape and structure of the hole in the middle of the hymen. The structure, shape and flexibility of the hymen are different in every woman. Whether bleeding occurs after the first sexual intercourse depends on the shape and structure of the hymen. Once the hymen is torn, it cannot be restored. Very thick or closed hymen that is not torn during the first intercourse can be easily opened by gynecologists by applying local anesthesia. Hymen repair can only be done by a gynecologist. The repair of the hymen can only be understood by a gynecologist examination or by an experienced forensic doctor examination.

When does the hymen bleed?

The hymen with thick edges and abundant veins bleed at the first intercourse, while the flexible and thin rimmed hymen with a rate of 2-5% may not bleed after the first sexual intercourse. While some women do not feel any pain during the first sexual intercourse, some women may have very severe pain. In some women, bleeding is negligible in the first intercourse, while in some women, the entire vagina with the hymen can be torn and taken to the hospital urgently with very severe bleeding.

The hymen can also be damaged after sexual intercourse, as a result of accidents and traumas, and after activities such as ballet that require wide opening of the legs.
If there is excessive and prolonged bleeding after the first intercourse, you should definitely go to the doctor. The doctor performs the necessary intervention with local or general anesthesia according to the degree of the tear. The first intervention is usually done with suture materials called vicryl under sterile conditions. Hymen repair is not done with laser. Since laser only cuts and burns, this technique is not used in hymen repair. After this intervention, it is appropriate not to have sexual intercourse for about a week to ten days until the wound heals. Re-bleeding usually does not occur after the wound has healed. However, if the hymen is hard and vascular, there may be short-term bleeding in subsequent relationships. If the amount of bleeding is not excessive, there is nothing to worry about.

Can the time of rupture in the hymen be determined?

However, as a result of the examination performed by a forensic doctor or gynecologist, the diagnosis of “torn hymen” is made. If more than 7-10 days pass after the first sexual intercourse, the time of the tears in the hymen cannot be determined. Fresh and old tears in the hymen are identified by the watch dial. In obese patients whose definitive diagnosis cannot be made and whose hymen is deeper, rectal examination (examination by the rectal route) can be performed to make the hymen more visible and more detailed information about the structure of the hymen can be obtained. According to the location of the tears, for example, at the 6-9 o’clock position, terms such as “old tear”, “new tear” are used. In addition, whether these tears reach the base of the hymen, whether it is a natural notch, and the findings such as hyperemia, bruising, and infection around the fresh tear should be stated in the report. The “natural notch” in some hymens does not occur with sexual intercourse, it is a congenital feature of the patient and is present in the anatomical structure of the hymen.

Can hymen repair be performed on every young girl?

Under the age of eighteen, hymen repair is not legally possible. Since this issue is usually hidden from the fathers, young girls under the age of eighteen must be accompanied by their mother and written consent of the mother must be obtained before the procedure. Having sex with more than one person before, having an abortion or giving birth does not prevent this process. Hymen repair can be applied to anyone. The person with whom you have intercourse does not understand that the hymen is repaired. However, it can be understood as a result of a gynecologist or forensic examination.

What are the reasons for erecting the hymen?

-Because those who lost their virginity for various reasons, especially before getting married, want bleeding during the wedding night due to social pressure,

-Because they care that everything is in accordance with the ritual before marriage, although they have had intercourse before,

-For being a fantasy on special occasions even though she’s been married for years

They want to have their hymen erected.

In hymen suturing, the number of relationships does not matter, the hymen can be sutured many times. Under local or general anesthesia, months or a few days before marriage, the hymen can be permanently or temporarily sutured so that it bleeds during intercourse. The hymen can never be restored. The intervention in the hymen repair process is to regenerate the hymen in a way that only causes bleeding.

What is the social significance of the hymen?

The hymen maintains its social and cultural importance in many cultures as well as in our country. In Muslim societies, the hymen is of great importance as evidence of whether there is sexual intercourse for the first time. The issue of virginity is a very important issue, especially in eastern societies. Despite this, a relief has been observed in all societies in this regard lately. Although some of the young people have sexual intercourse before marriage, since this subject is considered taboo, they want to have their hymen planted by coming together later.

Many young girls who do not bleed despite having sexual intercourse for the first time are examined by gynecologists on the grounds that they are not virgins. This atmosphere of insecurity, which is experienced even at the beginning of the marriage, often results in divorces. For this reason, it is very important to inform the society about the structure of the hymen and the mutual trust of the couples who will get married.

There are many newly married young girls who have a large hymen and are brought to the doctor because they do not bleed during the first sexual intercourse. Although it was explained that there was no bleeding due to the anatomical shape of the hymen and a medical board report was given that she was a virgin, it is witnessed especially in conservative circles that marriages ended due to insecurity just because there was no bleeding. This is a humiliating situation that leaves a deep wound in the souls of young girls, and many innocent young girls are unjustly accused and fall into situations that will affect their entire lives.

Should a hymen surgery be performed?

Due to the pressure of the general society in our country, there are requests for the operation of replanting the hymen for reasons that can be considered fantasy abroad. In a large part of our country, people resort to this procedure for fear of being killed and excluded from society. Although there are discussions all over the world about whether hymen repair is necessary or not, there is no consensus on this issue. While many western writers think that this procedure is unnecessary, some doctors say that this procedure is no different from other aesthetic operations, just as a person wants to change some parts of his body that he does not like with aesthetic operations, just as married women with wide vaginas have a vagina aesthetic operation. They argue that those who hear have the right to request aesthetic operations related to the hymen. On the other hand, there is also the deception part of the hymen repair. As physicians, we have to take care of every patient who comes. If the physicians reject this suggestion of the patient, the patient may go into a psychological depression and become helpless. Such a patient has already made an accounting of this in his inner world for days until he comes to the doctor. If his request is turned down, this may even cause his death if he comes from conservative religious circles. Although it is medically acceptable to help the patient in this regard, to reintegrate them into society, to improve their psychology and to work for their happiness, it is a controversial issue in terms of moral and social values.

How is the hymen suturing performed? (How is hymenoplasty done?)

Hymen suturing is called hymenoplasty. It is impossible to fully restore the membrane that has actually deteriorated. The sutures placed on the hymen, which has an extremely thin structure, are infected by many microorganisms in that area and the stitches do not hold. Although the membrane does not return to its original state, it is possible to create a new tissue that can bleed during intercourse by using different surgical methods such as pieces taken from the vaginal wall.

Hymen repair occurs in two ways. The first is the narrowing done by stitching 2-3 days before marriage. The second is the technique that is made by taking tissue from the vagina with the “flap” technique, which is made in the form of a patch, the duration of this operation is longer and it is about half an hour. The flap technique can also be done years before marriage. Both techniques are performed with local or general anesthesia according to the characteristics of the patient. The procedure is performed under sterile conditions in the gynecological position on the gynecological table. It is very important that the environment and tools are sterile during the hymen repair, in order to avoid infection later. Removing excess mucous from the posterior wall of the vagina or cutting the hymen too much during the flap method may cause problems during intercourse and excessive bleeding. If it is done in experienced and competent hands, these problems are almost never experienced. Even if the procedure is performed under general anesthesia, it is absolutely necessary to anesthetize locally so that there is no pain after the procedure. IV antibiotics and painkillers should also be administered to prevent infection during the procedure. After the procedure is finished, this area is cleaned with antiseptic solutions and closed sterile. Hymen repair is a process that takes about half an hour. After the procedure, the patient is awakened and rested for half an hour. He is then discharged with a prescription for oral antibiotics and painkillers and advised to change his underwear frequently. The patient who underwent hymenoplasty can return to normal work and strength after one hour. If the hymen has been transplanted with the flap method, it is absolutely necessary to go to the doctor for a check-up one week before the marriage.

Along with the hymen surgery, when the labia minora are misshapen, very large or asymmetrical, they can be given a normal shape with the operation called “labiaplasty”.

Kiss. Dr. Kutlugul Yuksel

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