Hymenotomy (Hymenectomy)
Hymenectomy should be more accurately named partial hymenectomy, or hymenotomy. The operation is done primarily to diminish the discomfort of initial coitus in a virginal woman or to relieve dyspareunia for a woman already sexually active. The hymen is a point of constriction for intravaginal intercourse, and its stretching or tearing can be a significant source of discomfort during an ordinarily pleasurable physiologic act.
The patient is anesthetized, placed in the lithotomy position, prepared, and draped. The hymen is gently grasped with Adson-Brown forceps at the 1-o’clock position and with an Allis clamp at the 5-o’clock position. The hymen is placed on gentle traction with special care taken not to tear it by excessive force. A 1 : 100 vasopressin solution has been injected subdermally via a 27-gauge needle into the vestibule side just lateral to the hymenal attachment (Fig. 75–1A
