Vaginoplasty is any number of genitoplasty surgical procedures done to the vagina, vulva or related structures; this includessurgery done to the labia majora, labia minora, clitoris, urethra, cervix, uterus, bartholin's gland, rectum, perineal musculature,lymphatics, urethral sphincter, anal sphincter, large blood vessels, and nerve tissue. Malignant growths and abscesses are removed and vaginoplasty recreates a normal vaginal structure and function. Vaginoplasty is also used to correct congenital defects to the vagina, urethra and rectum. Vaginoplasty can correct uterine and vaginal prolapse. Often, a vaginoplasty is performed to repair the vagina and its attached structures due to trauma. It will correct protrusion of the urinary bladder into the vagina and protrusion of the rectum into the vagina.
Female infants born with a 46,XX genotype but have genitalia affected by congenital adrenal hyperplasia will undergo the surgical creation of a vagina. Vaginoplasty is commonly used to treat women with the congenital absence of the vagina. Other reasons for the surgery include issues involving a microphallus, those who have Mayer-Rokitansky-Kustner disorder, and women who have had a vaginectomy after malignancy or trauma. It is done to reduce the size of the entrance of the vagina in some cases. In some instances, it is used to alter the appearance of the vulvar region.
Hysterectomy is the surgical removal of the uterus. It may also involve removal of the cervix, ovaries, fallopian tubes and other surrounding structures.
Usually performed by a gynecologist, hysterectomy may be total (removing the body, fundus, and cervix of the uterus; often called "complete") or partial (removal of the uterine body while leaving the cervix intact; also called "supracervical"). It is the most commonly performed gynecological surgical procedure. In 2003, over 600,000 hysterectomies were performed in the United States alone, of which over 90% were performed for benign conditions. Such rates being highest in the industrialized world has led to the major controversy that hysterectomies are being largely performed for unwarranted and unnecessary reasons.
Removal of the uterus renders the patient unable to bear children (as does removal of ovaries and fallopian tubes) and has surgical risks as well as long-term effects, so the surgery is normally recommended when other treatment options are not available or have failed. It is expected that the frequency of hysterectomies for non-malignant indications will fall as there are good alternatives in many cases.
Oophorectomy (removal of ovaries) is frequently done together with hysterectomy to decrease the risk of ovarian cancer. However, recent studies have shown that prophylactic oophorectomy without an urgent medical indication decreases a woman's long-term survival rates substantially and has other serious adverse effects. This effect is not limited to pre-menopausal women; even women who have already entered menopause were shown to have experienced a decrease in long-term survivability post-oophorectomy.