Hymenorrhaphy

Editors-In-Chief: Martin I. Newman, M.D., FACS, Cleveland Clinic Florida, [mailto:Newmanm@ccf.org]; Michel C. Samson, M.D., FRCSC, FACS [mailto:samsonm1@ccf.org]


 * Hymenoplasty redirects here. For the operation to correct an imperforate hymen, see Hymenotomy.

Overview
Hymenorrhaphy or hymen reconstruction surgery is the surgical restoration of the hymen. The term comes from the Greek words hymen meaning membrane, and raphe meaning suture. It is also known as hymenoplasty, although strictly this term would also include hymenotomy.

Such procedures are not generally regarded as part of mainstream gynecology, but are available from some plastic surgery centres, particularly in the USA, Japan and Western Europe, generally as day surgery. The normal aim is to cause bleeding during the wedding night, which in some cultures is a required proof of virginity.

Varieties of the operation
The term may cover at least four significantly different types of procedure:


 * Suturing of a tear in the hymen such as might be caused by sexual assault, soon after the assault, to facilitate healing.


 * A purely cosmetic procedure in which a membrane without blood supply is created, sometimes including a gelatin capsule of an artificial bloodlike substance. This operation is intended to be performed within a few days before an intended marriage.


 * Use of a flap of the vaginal lining, complete with its blood supply, to create a new hymen. Patients are advised to refrain from penetrative sex for up to three months following these procedures.


 * The term hymen reconstruction has also been used to describe some varieties of infibulation, requiring further surgery before penetration is possible.

Availability and legality
Some hymen reconstruction operations are legal in some countries, while other countries ban all hymenorrhaphy. Infibulation is in general illegal.

In the United States of America, hymen restoration is available in private clinics and becoming slightly more common.