Can Recurrent Vulvar Itching Be Treated with Surgery? Experts Say This

Many women may have had this experience: feeling vulvar itching, assuming it is vaginitis, and buying medication from a pharmacy for self-treatment, yet the inflammation recurs repeatedly…… In gynecology outpatient clinics, we often encounter female patients troubled by recurrent vulvovaginitis, urinary incontinence, asymmetry of the labia majora and minora, and hymenal damage. These issues are more “private” compared to other conditions, and most women in China may avoid discussing them. They may not realize that such conditions can be improved through gynecological surgery. In fact, for experienced gynecologists, these surgeries carry relatively low risk and can improve clinical symptoms through extensive surgical experience.

(In addition to surgery, other alternative treatment options are available. Patients can choose a plan suitable for their condition. Please consult a professional physician for details.)

Ms. Zhang, a 34-year-old female, had experienced recurrent vulvar itching and abnormal vaginal discharge for over 10 years. She had urinary leakage when laughing or coughing, and experienced odor during menstruation. She had visited multiple hospital gynecology clinics and was treated for suspected vaginitis, but the symptoms recurred. In the past week, she experienced stinging pain at the urethral opening, accompanied by frequent, urgent, and painful urination. She subsequently visited the gynecology clinic at HeYou Hospital, seeking advice on effective solutions to resolve the recurrent infections. After a thorough physical examination and relevant tests, Director Yang Xiaomei diagnosed her with abnormal vaginal discharge, and during laughter or coughing, she experienced urinary leakage, and had odor during menstruation. She had visited multiple hospital gynecology clinics and was treated for suspected vaginitis, but the symptoms recurred. In the past week, she experienced stinging pain at the urethral opening, accompanied by frequent, urgent, and painful urination. She subsequently visited the gynecology clinic at HeYou Hospital, seeking advice on effective solutions to resolve the recurrent infections. After a thorough physical examination and relevant tests, Director Yang Xiaomei diagnosed her with current fungal vaginitis, acute urinary tract infection, and stress urinary incontinence. Upon investigation, it was found that Ms. Zhang had old perineal laceration of grade II and anterior and posterior vaginal wall prolapse of grade I. In this condition, the protective effect of the vulva is weakened, leading to direct communication between the vagina and the external environment. Additionally, patients with these symptoms often use sanitary pads or panty liners almost daily, which, in the hot and humid summer, makes them more prone to vaginal and urethral infections. Director Yang recommended that after treating the urethral and vaginal infections, surgery could be considered to improve the current condition.

After anti-infection treatment, the patient was willing to undergo surgery. Based on Ms. Zhang's condition, Director Yang formulated a surgical plan: anterior and posterior vaginal wall repair combined with urethral plication. On the third day post-surgery, Ms. Zhang's vulvar wound healed well, and she was able to urinate normally after the catheter was removed. She was discharged after recovery. One month later, during a follow-up visit to the clinic, Ms. Zhang said: “I have seen many gynecologists before, and no one ever mentioned that surgery could be an option for this condition. I am grateful to Director Yang; everything feels great now.”

Ms. Wang, a 30-year-old female, had experienced a sensation of a foreign body, itching, and friction discomfort in the vulvar area for 15 years. In the past 2 months, the symptoms had worsened, prompting her to visit the gynecology department at HeYou Hospital. Examination revealed bilateral labia minora hypertrophy, with the maximum vertical distance from the outermost edge of the labia minora to the interlabial fissure being approximately 6 cm. She was diagnosed with grade III labia minora hypertrophy, which significantly affected her quality of life. Ms. Wang requested surgical treatment. Based on Ms. Wang's condition, Director Yang formulated a surgical plan: labia minora hypertrophy reduction surgery. Postoperatively, Ms. Wang recovered well with a natural appearance, which not only improved her clinical symptoms but also enhanced aesthetics. During her follow-up visit, Ms. Wang expressed her sincere gratitude.

Female vulvar plastic surgery is typically performed to improve quality of life and for aesthetic purposes. It includes procedures such as anterior and posterior vaginal wall repair, old laceration repair, labia minora hypertrophy correction, vaginal tightening, and hymen repair.

1. Perineal Reconstructive Surgery:

   ① Enlargement of the genital hiatus, vaginal laxity, and decreased sexual satisfaction caused by varying degrees of perineal body injury;

   ② Old perineal body old laceration of grade II or above with scar formation, perineal structural damage, and functional impairment;

   ③ Excessive descent of the perineal body leading to urinary and defecation dysfunction, etc.

2. Hymenal Atresia Incision and Plastic Surgery:

   Congenital hymenal developmental disorders, stenosis, atresia, or scarring, thickening, etc., leading to menstrual blood retention, obstructed menstrual flow, and dyspareunia.

3. Hymenal Rupture Repair and Plastic Surgery:

   Plastic surgery performed to restore the general anatomical morphology of the hymen. Indications include hymenal rupture, individuals with a clear subjective desire for the procedure, and cases where perineal body injury repair is required for various reasons, sometimes necessitating concomitant hymenal (or hymenal rim) repair and plastic surgery.

4. Labia Minora Hypertrophy or Asymmetry Plastic Surgery:

   Indicated for individuals with a desire for labia minora reconstruction and who meet the following criteria: labia minora hypertrophy, significant bilateral asymmetry, rough and thick texture, labia minora