Surgery for Vulvar Lichen Sclerosus Sequelae
Medical treatment for VLS can control active disease, but it does not reverse established anatomical changes. When these sequelae significantly affect quality of life, reconstructive surgery may be the indicated option.
Sequelae that may require surgery
Surgery in the context of VLS does not treat the disease itself—it addresses the anatomical consequences that chronic inflammation has produced on vulvar tissue. The most frequent indications are:
Severe introital narrowing
Progressive fibrosis can reduce the vaginal opening to the point of making sexual intercourse impossible or very painful and, in extreme cases, making gynecological examination difficult. Vulvoplasty or perineoplasty can restore a caliber that allows for sexual function and adequate gynecological follow-up.
Advanced labia minora fusion
Adhesion of the labia minora to the clitoral body or to each other can lead to retention of secretions, difficulty with hygiene, and functional problems. Surgical release of adhesions resolves these issues.
Symptomatic clitoral phimosis
The clitoral hood can adhere and cover the glans, leading to smegma retention, recurrent infections, and loss of sensitivity. Surgical release, when properly indicated, can improve function and eliminate symptoms.
Why surgery cannot be performed alone
This point is clinically critical and should be emphasized: operating without active disease control significantly increases the risk of cicatricial recurrence.
Vulvar tissue with active VLS has altered healing capacity—chronic inflammation interferes with the repair process and can produce fibrous scars that reproduce or worsen the initial sequelae.
Therefore, surgery must always be planned in the context of medical treatment that has the disease well controlled before the intervention, and treatment must be maintained after surgery as part of long-term follow-up.
Specialization is essential
Reconstructive vulvar surgery in the context of VLS requires a specialist with specific experience in this type of intervention. It is not standard gynecological surgery nor conventional aesthetic genital surgery: it is functional reconstructive surgery on tissue with specific characteristics that the specialist must understand.
For surgery for vulvar lichen sclerosus sequelae, we collaborate with the team at cirugiavaginal.info, specialized in reconstructive vulvar and vaginal surgery. If, after evaluation at our clinic, surgical indication is determined, we can guide you to the appropriate specialists.