Hymenoplasty Experience: Factors Associated with Dehiscence (Hymenoplasty Complications)

Abstract

Purpose: To evaluate outcome of hymenoplasties in private clinics and investigate the factors affecting the risk of dehiscence Method: A retrospective cross-sectional survey of Obstetrics and Gynecology specialists trained over the last five years was conducted. Specialists from private clinics completed surveys on hymenoplasties performed. Rates and types of complications were requested and factors associated with wound dehiscence in patients undergoing permanent hymenoplasty was investigated with multivariate analysis. Results:. A total of 968 patients were included. Hymenoplasty was performed for revirgination in 874 cases (90.2%), incision of the hymen for gynecological procedures in 82 (8.4%) cases and trauma in 12 cases (1.2%). Complications included wound dehiscence (26.1%), infection (1.7%), bleeding (1.7%), pain (1.5%), itching (1.4%) and dyspareunia (0.5%). The technique was permanent in 714 cases and temporary in 254 cases. Among the permanent hymenoplaty cases, multivariate logistic regression analysis showed that obesity (OR=3.1, 95%CI: 1.5-6.2, p=0.001) and tobacco use (OR=2.2, 95%CI: 1.3-3.8, p=0.003) increases the risk of dehiscence. Sedation decreased the risk of dehiscence when compared to local infiltration anesthesia (OR=0.56, 95%CI: 0.33-0.99, p=0.04). Every decrease in the polyglactin suture caliber decreased the risk of dehiscence (OR=0.22, 95%CI: 0.16-0.3, p<0.001) This study showed that using 5.0 sutures, omitting infiltration anesthesia, and avoiding tobacco use may help decrease wound dehiscence after hymenoplasty.