Women who desire to undergo hymen reconstruction surgery but have bleeding disorders have been advised against the procedure by surgeons.
The plastic and maternal health surgeons, who spoke to PUNCH Healthwise in separate exclusive interviews, noted that although the procedure is not commonly done in Nigeria, women whose blood cannot clot properly should stay away from avoidable surgeries.
Bleeding disorders, according to the American Society of Haematology, are a group of conditions that result when the blood cannot clot properly.
Hymen reconstruction or repair surgery, also known as Hymenoplasty, is the procedure to repair a torn hymen or reconstruct a missing hymen, according to the Plastic Surgery Clinic, a Canada-based beauty clinic.
According to Cleveland Clinic, an online health portal, the hymen is a small, thin piece of tissue that surrounds or covers the vagina.
The presence of the hymen is mostly attributed to sexual inactivity as it is believed to be accompanied by bleeding when broken during the first sexual activity.
However, Cleveland Clinic says the hymen stretches and thins over time because of day-to-day activities or from using tampons, and cannot grow back after it breaks.
According to the Plastic Surgery Clinic website, more women are opting for hymenoplasty to satisfy religious and cultural beliefs.
It also stated that while some sought the procedure as a psychological and emotional relief following sexual abuse or trauma, others desired it to repair an injured hymen caused by other factors outside sex.
To increase self-confidence, have a sense of beauty, and have the hymen ruptured on the wedding night or with a new sexual partner were some of the reasons some medical cosmetic blogs highlighted as reasons to undergo hymenoplasty.
Women’s Health Services of Maryland notes that one in 1,000 women are born without a hymen.
It further listed bruising and swelling, hematomas and bleeding, discolouration of the hymen, numbness, intense pain, faintness, rare or foul-smelling discharge, excessive itching, irregular bleeding and inflammation as complications associated with the procedure.
According to a medical blog, the total cost for Hymenoplasty in Nigeria done by Indian cosmetic surgeons was between $3,000 and 3,200.
Speaking with PUNCH Healthwise, a Professor of Plastic and Reconstructive Surgery at the Nnamdi Azikiwe University, Awka, Anama State, Titus Chukwuanukwu, said some women undergo hymenoplasty as an escape from the societal consequences of premarital sex.
He noted that although hymenoplasty was done in Nigeria, the procedure was common in Western countries.
“Both hymenoplasty and vaginal tightening surgeries are done in Nigeria. Hymenoplasty has not become popular in most parts of the country but many who are more ‘civilised’ in their approach to life may do it. So, hymenoplasty is done in Nigeria but it is not as popular as in other countries. However, the vaginal tightening procedure is the one usually requested,” the don added.
The surgeon advised women with bleeding disorders against “doing avoidable surgeries generally and hymenoplasty inclusive.”
Chukwuanukwu further noted that women who have had several sexual partners and feel that their vagina is loose and want to have it tightened requested vagina tightening procedures.
The don also pointed out that women, who have had many vaginal births or those who had several cases of vaginal tears during childbirth and feel that their vagina was lax, could want to undergo the vaginal tightening surgery.
The plastic and reconstructive surgeon also said that hymenoplasty was not restricted to a particular age range.
“Most times, those who are single and want to restore their ‘virginity’ are those who opt for it. Those living in areas where importance is placed on virginity can have hymenoplasty commonly done,” he noted.
Speaking on the implications of hymenoplasty on future vagina births, the dons stated that the artificial hymen would have been broken after sexual contact.
“The surgery is to restore the hymen, which is a sheet covering the entrance of the vagina. But the vagina opening is not closed completely to ensure the flow of menstrual fluid. So, at sexual contact, that part is further opened,” he explained.
However, for women of childbearing age who have undergone vaginal tightening, the don said they are at risk of further wear and tear of the vagina.
Chukwuanukwu said, “When the woman is still in childbearing age, we usually advise that they complete the number of babies they want to have. If for any reason the person is not ready to do that, it is done in such a way that it would not interfere with childbirth but we explain the possibility of the vaginal becoming lax again.
“The major issue with our environment here is that at the delivery of their babies, if they are not properly supervised, the babies cannot come out, surgery is done to widen the birth canal and after the baby is born, a surgery is done to close it up neatly so that it heals and returns to his original state. But if the delivery is not well supervised and there is a tear, if it is not properly sutured, it can heal but then leave the vaginal entrance gaping which is not appealing.”
The surgeon further noted that although hymenoplasty could be done repeatedly, it is not proof of virginity.
“Virginity is not only proven by the presence of the hymen. There are several ways that a man can detect that a woman has been sexually exposed. Hymenoplasty is, therefore, not a guarantee that the man will be deceived.”
Also, a Professor of Obstetrics and Gynaecology at the University of Uyo, Akwa Ibom State, Aniekan Abasiattai, noted that hymenoplasty was increasingly being done in the developed world to reform and rebuild the hymen.
He said several procedures to repair, reconstruct or construct the birth canal caused by birth complications, female genital mutilation or extensive scarring are common medical procedures in Nigeria.
He, however, noted that studies on the long-term outcomes, complications and safety of the procedures when carried out for cosmetic purposes have not yet been carried out.
The don stated that pain, bleeding and the side effects of anaesthesia, which are known complications of surgical procedures, could also present in hymenoplasty surgery.
Abasiattai said, “The standard recorded side effects of performing such a procedure include the possibility of haemorrhage because the vagina has a lot of vessels. Pain and the anaesthetic risk are other factors. Dexterity is needed in performing such procedures because other adjacent organs could be injured in the process. The bladder is superiorly related and the rectum is below, so you either inure the bladder inadvertently or even the tube that leads from the bladder to the exterior, which is the urethra. As a result, such a person comes down with involuntary leakage of urine or faeces as the case may be.
“When one has an injury, sometimes it heals with scar tissue formation and the natural tendency for the person to develop a lot of scars would cause excessive scarring around the entrance of the vagina that would lead to keloid formation and sometimes, depending on the extensive nature of the procedure, the person could come down with sexual problems that include sexual dysfunction, pain during sex, difficult penetration, absence of menstrual flow and during labour, there can be difficulty in delivery leading to long obstructed labour and severe bleeding.”
The researcher in community obstetrics, reproductive health and foetal-maternal medicine further advised women to seek thorough medical examinations before undergoing surgical procedures for cosmetic or repair procedures.
