Surgery for Vulvodynia (Vestibulectomy)

A vestibulectomy is a procedure for patients suffering from vulvodynia to remove the tender areas of skin between the lower vagina and just within the vulva. The extent of tissue removal during this procedure varies and is contingent on your specific symptoms and the surgeon overseeing your treatment. In certain cases, only small, localised areas of skin from the lower portion of the vestibule are excised. However, for women experiencing more extensive symptoms, larger sections of the vestibule can be removed, extending toward the front of the vagina near the urethra, where urine is passed. Additionally, less common procedures involve the removal of labial skin and skin around the anal area. These surgical interventions are typically performed in a hospital setting under general anaesthesia, with a duration ranging from 10 to 40 minutes, depending on the surgeon's approach.

Surgery is typically considered a suitable option for women dealing with vestibulodynia, which is characterised by localized pain in the vestibular area upon touch. This hallmark symptom often prompts the removal of the sensitive skin in that region, resulting in relief and success for some individuals. Nevertheless, the primary approach to managing vestibulodynia is medical, and only a minority of patients opt for surgical intervention. While surgery remains infrequent for this condition, it can be highly effective when carefully chosen for specific patients.