Display Patient Information Leaflets

Date issued: April 2025  

For review: April 2027

Ref: A-197/gynae/ GB/double z plasty with v-y advancement v3

PDF: Double Z plasty with V-Y advancement final April 2025 v3.pdf [pdf] 195KB

Narrowing or distortion of the vaginal opening can occur for a variety of reasons. This is quite often accompanied by a flap of skin at the 6 o’clock position, which splits when put on the stretch, for example during intercourse.

The traditional operation to put this right is a Fenton’s procedure.  However, this does not always work.  Double Z plasty with V – Y advancement, a standard technique in plastic surgery for the release of scar contractures, was first used here at Derriford Hospital in 2005 for a patient in whom a Fenton’s operation had been unsuccessful.

Following the success of the double Z plasty procedure on that occasion we have operated on many patients, the majority of whom have been very pleased with the results.

The operation 

The operation takes about thirty minutes to perform and is carried out as a day case. It can be done under local or general anaesthetic depending on patient preference.

This is NOT major surgery.

Post-operative recovery 

After the operation it is advisable to take things easy for a week or 2.  All the stitches dissolve and do not need to be removed.

Pain

The amount of pain patients experience seems to vary considerably both in the amount and duration.  Pain relief with regular tablets of paracetamol and an anti- inflammatory pain killer e.g. Ibuprofen is usually all that is required.

Healing

Complete healing is usually achieved by 3 to 4 weeks.  If there are any signs of infection, then a course of antibiotic tablets may be required, these can be prescribed by your GP.

• Signs of infection are redness.

• Unpleasant smelling discharge.

• Increasing levels of pain.

It is probably best to avoid taking a bath for 2 or 3 days until the healing is complete.  Keeping the area clean is best achieved by showering twice a day.  There is no need to apply any antiseptic solutions.

Remember

Please do not pull off any scabs as they protect the new tissues underneath and act as “natural dressing”. They will fall off without any help when ready.

Bowel and bladder function

Bladder function should not be affected. Some patients have noted that having their bowels open can be quite uncomfortable during the first 2 or 3 weeks of the healing phase.  

Constipation is best avoided, and you may want to take a natural laxative, e.g. Movicol, if this is likely to be a problem.

Return to normal activities

Be sensible.  Normal everyday activities are fine from the start, but you may want to put your feet up from time to time. 

Return to work really depends on how physical your job is, and you may need 1 or 2 weeks off.  You can drive a car as soon as you feel comfortable to do so.

Avoid swimming or any intense exercise until the healing is complete, about 4 weeks.

Sexual Intercourse

The time taken before attempting to have sex varies enormously from 1 patient to another.  On average, 6 weeks is about right.  However, if everything has healed well and you feel comfortable you may try before then.  You may of course feel you need a little longer to feel comfortable and confident.

Take things easy at first. As inevitably the area will still feel sensitive, even though there should be no slitting of the skin.

Post-operative review

We usually see patients at around 6 weeks in the Outpatient clinic.  If you have any concerns in the meantime, please contact Ocean Suite and speak to a nurse within the triage team on 01752 432624 (24hrs)

Remember 

•  Tell your family you may not be your usual self for a while after getting home.

•  Rest when you feel tired. Listen to your body.

•  Resume your normal daily activities as soon as possible.

•  Have a shower twice every day and ensure that you pat dry the area.

•  Make sure you do not get constipated.

•  Do not go back to work until you are ready.

•  Talk to your husband or partner about how you both feel about the operation.

•  And of course, do your pelvic floor exercises for the rest of your life.

Thank you for taking time to read this leaflet, if you have any queries or worries, please do not hesitate to speak to the  pre-operative assessment nurse or the nurses on the ward.

If you think of any questions you wish to ask the nurses or your Consultant, write them down on the opposite page so that you do not forget.