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Recently, I came across an article in “The Indian Journal of Surgery”, where an author describes about hymenoplasty. I had neither come across such a topic in the text book of surgery nor was taught about it. So, I went through it and thought to project my view point on the subject, obviously here in this forum. Hymen, a Greek word means a membrane. Anatomically, this is a membranous structure positioned in the junction of vulva and vagina in woman genital tract. Developmentally, these two parts of female genital organ are from separate entities. The meeting point is marked by the membrane called hymen. It is either annular, crescentic or circular in shape. It may have one or several holes in it, communicating the vulva and vagina. Sometimes, it is imperforated giving rise to a condition called cryptomenorrhia, where there is obstruction to the menstrual flow after puberty, necessitating a surgical correction.

Traditionally, the credit of its rapture is given to first intercourse in the nuptial night. The first blood seen in the clothing is taken for granted as loss of virginity for the first time, much to the delight of the partner and the lady herself. And that is the origin of the problem and solution in the form of hymenoplasty in recent days. At the same time, I do not think many give an importance to not seeing blood at that night. The author describes the reason to embark upon the surgery to be social belief as described and moral boosting of lady, in establishing the virginity before marriage. Here are some of the facts well documented in forensic science; A hymen may be

• totally absent from birth
• imperforate
• may not tear after repeated intercourse
• tear due to some sports activity
• tear with introduction of some surgical devices during a gynecological examination
• show tears due to introduction of masturbating devices
• tear due to sanitary tampons

and

• even it may remain intact till the first delivery to take place.

So, one may not see blood in the first eventful conjugal night. Question here is who seeks this procedure? Is it as a result of a fear of a guilty mind? Or, is it due to the gain in knowledge about the hymen? Now-a-days premarital sexual relation is in rise and that perhaps sitting in the mind of a lady, forcing for such a procedure. Are all the boys chaste by the time of marriage? It is a fact that, somebody seeking such a procedure for any reason should not be denied. At the same time, the procedure should be standardized by a group of doctors and the adverse effects be well documented. But, how far this procedure will succeed in giving a spotting in the first conjugal night is doubtful, as many a times it does not tear and remains intact. Therefore, before jumping to undergo and perform the procedure, all involved should clearly understand the natural history of the fate of hymen, on and after the nuptial night. I do not think many are interested to see blood on that night. On the contrary, may panic by the sight of blood. More evaluation is probably the answer.

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