title: Backgrounds of women applying for hymen reconstruction, the effects of counselling on myths and misunderstandings about virginity, and the results of hymen reconstruction.
abstract: ABSTRACT   Objective To study the backgrounds of women requesting hymen 'repair', to assess the effects of extensive counselling, and the effects of hymen reconstruction.   Methods A two-centre qualitative study, consisting of a semi-structured interview, education, discussion of alternatives, and instructions for self-examination (first visit), educational examination (second visit), decision on operation or alternative (third visit), and follow-up (fourth visit).   Results Eighty-two women were interviewed at first visit. Sixty-eight women were followed until their decision to be operated upon or not. Forty-eight percent of all subjects reported a history of sexual violence, and 37% had had one or more abortions. Only 29% eventually decided to be operated. Seventeen of the 19 women who submitted to an operation and attended the follow-up visit reported no blood loss at first marital intercourse.   Conclusions Most women requesting hymen reconstruction had a history complicated by critical life events related to their request. All women were afraid they would not bleed and/or would not be 'tight' enough during the wedding night. For 75% of the women empowerment by means of extensive counselling resulted in a decision against operation. Hymenoplasty alone does not help women because most operated women will not bleed and because they often also have to prove to be 'tight' enough.
authors.affiliation: Department of Obstetrics and Gynaecology, St Lucas/Andreas Hospital, Amsterdam, the Netherlands.
authors.forename: Bianca R
authors.initials: BR
authors.lastname: van Moorst
authors.forename: Rik H W
authors.initials: RH
authors.lastname: van Lunsen
authors.forename: Dorenda K E
authors.initials: DK
authors.lastname: van Dijken
authors.forename: Concetta M
authors.initials: CM
authors.lastname: Salvatore
mesh_terms: D000028:Abortion, Induced; D000293:Adolescent; D000328:Adult; D003376:Counseling; D003657:Decision Making; D004521:Educational Measurement; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006924:Hymen / Q000098:blood supply / Q000601:surgery*; D007407:Interviews as Topic; D008016:Life Change Events; D009426:Netherlands; D010043:Outcome and Process Assessment, Health Care; D019651:Plastic Surgery Procedures / Q000523:psychology*; D016353:Self-Examination; D012746:Sexual Abstinence / Q000523:psychology