Vestibulectomy
The vestibulectomy is an outpatient procedure to treat some types of vestibulodynia, it is typically our “last resort” step for patients with vestibule pain after they have tried other more conservative options including pelvic floor physical therapy and local hormone therapy, among a few others. This surgery removes the painful tissue surrounding the opening of the vagina. To determine if you are a good candidate for this surgery, we do a “vestibular anesthesia test” (VAT) in the office where we apply topical numbing cream to the vestibule and repeat a pelvic exam to assess your pain. If during the VAT, your pain goes away (completely or partially) you may be a good candidate for the vestibulectomy.
The procedure comes with some possibility of complications including Bartholin Cyst formation and the continuation of persistent pelvic pain. Following the surgery, the vulvar area will be sore and swollen for several days to weeks, and we recommend you start pelvic floor physical therapy 6 weeks after surgery. Of our patients, 97% of those who go on to have the surgery had their most bothersome symptom improved by the operation. And 100% of our patients who had the vestibulectomy reported that they would choose to have the surgery again.