Vulvoplasty (Episioplasty) in Dogs

What is a vulvoplasty?

Vulvoplasty, also called episioplasty, is a surgical procedure used to correct a recessed vulva. Dogs with this condition have excess skin folds that partially cover the vulva, which can lead to irritation or infection.

During a vulvoplasty, your veterinarian removes a small amount of tissue above the vulva to reduce these folds and expose the vulva more normally.

Why would my veterinarian recommend a vulvoplasty?

In a dog with a recessed vulva, folds of skin and fat hang over the vulva. These skin folds often trap urine, leading to a warm, moist environment that allows bacteria to grow. Affected dogs may develop inflammation or infection of the skin folds, vaginitis (vaginal inflammation or infection), or urinary tract infections. 

Dogs may experience recurrent infections, requiring long-term treatment with topical or oral antibiotics. In some cases, recurrent or long-term use of antibiotics may lead to antibiotic-resistant infections. Restoring the normal conformation of the vulva helps improve ventilation in this area, allowing the skin to dry and making it more difficult for bacteria to grow. Additionally, this surgery prevents skin layers from rubbing together and further contributing to vulvar inflammation.

What preparation will my pet need before vulvoplasty?

Before surgery, it is important to resolve any skin infection around the vulva, because infection at the surgery site could prevent the wound from healing normally. In many cases, clearing the infection requires a course of oral antibiotics. If your veterinarian suspects an antibiotic-resistant infection, they can perform bacterial cultures to guide the choice of an appropriate antibiotic.

Your veterinarian may also recommend pre-anesthetic bloodwork. This bloodwork allows your veterinarian to assess your dog's white and red blood cell counts, platelet counts, and serum biochemistry profile before surgery. Normal pre-anesthetic bloodwork assures your veterinarian that your pet is a good candidate for anesthesia. If your pet has abnormalities in their bloodwork, they may need to be addressed prior to surgery.

Your veterinarian will also provide you with instructions regarding food and water intake prior to anesthesia. In most cases, you must withhold food starting the evening before surgery, because a full stomach may increase the risk that your pet will vomit during or after anesthesia.

How is a vulvoplasty surgery performed?

A vulvoplasty is performed under general anesthesia. During surgery, your veterinarian will remove a crescent-shaped piece of tissue (skin and possibly some underlying fat) above and extending down both sides of the vulva. The size of the tissue crescent that is removed depends on the severity of your dog’s recessed vulva. 

Once this tissue is removed, the cut edges of the remaining skin will be stitched together. This procedure lifts the skin fold, allowing the vulva to be exposed to the air.

What is the expected recovery after a vulvoplasty?

After surgery, your pet will go home with a nonsteroidal anti-inflammatory drug (NSAID) to prevent pain and swelling at the surgical site. It is important that you give this medication as directed, to keep your dog comfortable and minimize surgical complications. Your dog may also go home with an antibiotic, to prevent infection of the incision. Your dog may have skin sutures after this surgery, which must be removed in 10 to 14 days.

For the first two weeks after surgery, it is very important that you keep your dog calm and restrict their activity. Excessive running or jumping could cause the incision to open, leading to significant complications. It is also important that your dog wears an E-collar (cone) for the first one to two weeks after surgery. The E-collar prevents your dog from licking the incision, which interferes with healing and could lead to infection.

What is the prognosis after vulvoplasty?

In general, the prognosis for a dog after a vulvoplasty is excellent. The most significant complication that can occur is dehiscence (opening up) of the wound. This can occur if an excessive amount of tissue is removed and the wound is closed under tension, or if a pet is excessively active in the postoperative period. Limiting your dog’s activity after surgery and using an E-collar consistently are the best ways to prevent dehiscence.

Another possible complication of vulvoplasty is that an inadequate amount of tissue might be removed. If this occurs, the clinical signs of a recessed vulva may persist because the problem is not fully resolved. Rarely, a dog might need a second surgery to further correct the problem.