Precautions for diatomite surgery

The hymen is located inside the vagina. If a woman has certain problems and needs special treatment, a hymenotomy is required. Both the hymen and the vagina are relatively fragile, so you must be very careful when performing a hymenotomy, and the patient also needs to pay attention to certain matters after the operation. Here we will introduce you to the relevant knowledge about hymenotomy!

1. Indications

The hymen is located between the vulvar canal and the urogenital sinus. When the vagina and vulva differentiate, the originally closed hymen is perforated to connect the vagina and the vaginal vestibule, and the unperforated hymen becomes an imperforate hymen. It is often found when people seek medical attention for lower abdominal pain, dysuria, and pelvic mass caused by primary amenorrhea and intrauterine blood.

Hymenotomy is indicated for:

1. After puberty, if there is no menstruation and periodic lower abdominal pain occurs, it may lead to blood accumulation in the vagina, uterus, and fallopian tubes, and secondary pelvic endometriosis or infection. Once diagnosed, surgery should be performed as soon as possible.

2. For young girls with imperforate hymen, surgery can be performed after their development is slightly more mature.

2. Surgical steps

1. First puncture the center of the bulging part of the vaginal opening to understand the thickness and contents of the atretic hymen. Generally, a small amount of accumulated menstrual blood can be extracted.

2. Make an "X"-shaped incision at the protruding part of the vaginal opening. The incision line can reach close to the hymen ring to fully discharge the menstrual blood retained in the vagina.

3. After wiping away the accumulated blood, check the vagina and cervix for deformities or stenosis. Use a probe to probe the uterine cavity and cervical canal. A small dilator can be used to dilate the cervix so that the accumulated blood in the uterine cavity can flow out. The blood accumulated in the fallopian tube can be discharged gradually. Be careful not to press the abdomen or uterus during the operation to avoid the menstrual blood flowing back into the abdominal cavity or the rupture of the blood accumulated in the fallopian tube.

4. Trim the cutting edge of the hymen to form a circular hymen opening.

5. The cut edge of the hymen can be sutured intermittently with 2-0 or 3-0 absorbable sutures. If there is no bleeding at the cut edge of the hymen, no suture is required.

3. Postoperative treatment

The following treatments are done after hymenotomy:

1. Take a semi-recumbent position. You can sit up or get out of bed to move around after the operation to facilitate menstrual blood drainage.

2. Keep the vulva clean. Avoid sitz baths or vaginal lavage to prevent ascending infection.

3. For those with thick atretic hymen tissue, a vaginal model can be placed to avoid contracture of the incision edge or vaginal stenosis.