Concierge gynaecology · UK
Fenton’s procedure — widening a tight or scarred vaginal opening.
A short perineal repair for superficial pain at the vaginal entrance, by a consultant gynaecologist with a special interest in vulval and perineal repair — with the non-surgical options considered first.
Why patients choose us
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A consultant gynaecologist, in theatre
Not a walk-in clinic and not a rushed appointment. A named gynaecologist with a special interest in vulval and perineal repair, in a proper theatre.
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Non-surgical options tried first
Vaginal oestrogen, dilators, pelvic-floor physiotherapy and psychosexual support — considered before we ever recommend a knife.
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Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What a private Fenton’s procedure costs in the UK.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options. NHS-funded when clinically indicated.
In short
A Fenton’s under LA and sedation in our network: £2,000–£3,500, home the same day.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Fenton’s procedure under LA + sedation | £2,000–£3,500 | 30–40 min | Same visit |
| Fenton’s procedure under short GA | £2,800–£4,000 | Half-day | Same visit |
| Perineoplasty (more extensive repair) | £3,000–£5,500 | 45–60 min | Same visit |
| Z-plasty for radial scar | £2,500–£4,500 | 45 min | Same visit |
| Consultant vulval / menopause clinic | £250–£450 | 45 min | Same visit |
| Pelvic-floor physiotherapy (per session) | £90–£150 | 45–60 min | Same visit |
Prices vary by clinic, by the gynaecologist doing the case, by the anaesthetic chosen, and by whether any extra work is added on the day. We come back with a firm quote within one working day.
The problem
The right clinician, the right diagnosis, the right sequence.
Painful sex at the entrance is one of the most misattributed complaints in gynaecology — often labelled “tight” when the real cause is vaginismus, vulvodynia or a hypertonic pelvic floor. Getting the diagnosis right is what makes a Fenton’s work.
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Not sure it is surgical?
A vulval or menopause clinic assessment — with pelvic-floor examination and Q-tip test — comes first. We say if surgery is not the answer.
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Tried physiotherapy and dilators?
Non-surgical measures should be optimised before a repair. If they have been tried properly, a Fenton’s becomes a fair option.
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Want it done properly?
A named consultant gynaecologist with special-interest in vulval and perineal repair, in a proper day-case theatre with the anaesthetic you choose.
The journey
From enquiry to recovery — what happens, in order.
One clinician from first message to review — including the recovery window and physiotherapy follow-through.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
A few hours at the clinic
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Where the pain is, how long it has been there, and what you have already tried.
- 02
Before
We come back with a recommendation
Within one working day: the right clinician, whether non-surgical options should come first, and an indicative price.
- 03
Before
We arrange the appointment
Usually within one to two weeks. Your medications are reviewed and you are told exactly how to prepare.
- 04
On the day
Arrival at the clinic
Consent and a chat with the gynaecologist and anaesthetist. Local with sedation or a short GA — whichever was chosen.
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On the day
The procedure itself
20 to 40 minutes in a proper theatre. Longitudinal incision through the scar, transverse closure, dissolvable stitches.
- 06
On the day
Home the same day
A short recovery, written aftercare, and home within a few hours. If you had sedation or GA you will need someone to collect you.
- 07
After
Recovery and review
A one to two-week review in clinic. No intercourse for six weeks. Pelvic-floor physio and dilator work usually follow.
Typical end-to-end: 2–3 weeks from enquiry to procedure. Full healing: 6 weeks to intercourse, 3–6 months to full comfort.
When it helps
When a Fenton’s procedure is the right step.
The situations we see most, and the two important pauses — the misdiagnosis trap and the red flag that changes the appointment.
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Superficial dyspareunia (entry pain)
A sharp, burning or tearing pain at the vaginal opening on penetration — the classic reason to consider a Fenton’s.
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Posterior fourchette scarring
A tight, pale scar at the back of the vaginal opening after childbirth tear, episiotomy or repeated splitting.
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Lichen sclerosus with introital stenosis
Scarring from lichen sclerosus that has narrowed the introitus — after topical steroid treatment has been optimised.
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Splitting on intercourse
A scar that tears every time, then heals shorter — a Fenton’s widens the opening perpendicular to the split.
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Failed conservative measures
Vaginal oestrogen, dilator therapy, lubrication and pelvic-floor physio have been tried and the pain remains at the introitus.
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Post-radiotherapy or scleroderma stenosis
Scarring from pelvic radiotherapy or connective-tissue disease that has narrowed the vaginal entrance.
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Consider carefully — not everyone
Vaginismus, vulvodynia and hypertonic pelvic floor feel similar but do not respond to surgery. A careful assessment matters.
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Red flag: unexplained bleeding or lump
New vulval bleeding, an ulcer, a lump or a rapidly changing lesion needs same-week gynaecology review, not a repair booking.
Procedure options
A Fenton’s is one option among several.
What each option actually involves — and which fits which problem. Sometimes the right answer is not surgery at all.
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Fenton’s procedure (classic)
A longitudinal cut through the scar at the posterior fourchette, closed transversely. Widens the opening on the same principle as a Heineke–Mikulicz pyloroplasty.
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LA + sedation
Local anaesthetic infiltration with light sedation. Comfortable, quick, and home the same day — the option most patients choose.
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Short general anaesthetic
Asleep for 20 to 40 minutes with an anaesthetist. Preferred if you are very anxious or would rather not be aware.
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Perineoplasty
A more extensive repair reshaping the perineal body — considered when the scarring extends beyond the fourchette.
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Z-plasty
A tissue-rearrangement technique for radial or contracted scars — used when a straight transverse closure would not release the tension.
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Vulvar reconstruction for LS
For advanced lichen sclerosus stenosis, sometimes a more extensive reconstruction is needed — planned with a vulval-disease specialist.
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Non-surgical pathway
Vaginal oestrogen, dilator therapy, pelvic-floor physiotherapy and psychosexual support — often the right first step, and sometimes the only step needed.
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Consultation only
An honest discussion of whether surgery is needed at all, and which option fits — no obligation.
Our vetted UK network
A small panel of gynaecologists, we picked them.
Consultant gynaecologists with a special interest in vulval and perineal repair, across the major UK private clinics. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every gynaecologist in our network.
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Consultant gynaecologists with a special interest in vulval and perineal repair
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Multidisciplinary review — physiotherapy, menopause and psychosexual input where relevant
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Non-surgical options offered and optimised before any operation
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RCOG-aligned technique, dissolvable sutures, day-case theatre standards
Safety and recovery
What to expect afterwards — honestly.
A Fenton’s is a common, safe day-case procedure. The things worth planning are your anaesthetic choice, the six-week no-intercourse window, and the follow-through — physiotherapy, dilator work and gentle re-introduction.
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LA with sedation, or short GA
Choice matters. Sedation is quick and lets you go home the same day; GA suits those who would rather not be aware at all.
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Brief bleeding and swelling
Some spotting, bruising and swelling for one to two weeks is normal. Significant bleeding is uncommon and the team is prepared.
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No intercourse for six weeks
The wound needs to heal properly. Sex too early is the commonest cause of stitch problems and scar re-splitting.
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Dissolvable stitches
Vicryl Rapide or similar — the stitches dissolve on their own over two to four weeks. No removal appointment is needed.
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Sitz baths and shower, not baths
Shower normally from day one and use warm sitz baths for comfort. Avoid soaking baths and swimming for one to two weeks.
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The scar softens over months
The repair looks pink and firm at first, then fades and softens over three to six months. Gentle vitamin E oil massage can help.
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Dehiscence risk in smokers and diabetics
Wound breakdown is uncommon but more likely if you smoke or have poorly controlled diabetes — worth optimising beforehand.
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Persistent pain may mean misdiagnosis
If pain continues after healing, the original problem may have been vulvodynia, vaginismus or a hypertonic pelvic floor — not something surgery could fix.
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Red flags
Fever, spreading redness, heavy bleeding or the wound opening are not normal — call the clinic or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever technique was used, the note the gynaecologist sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly — we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and method chosen
Why the procedure was done — post-childbirth scar, lichen sclerosus stenosis, radiotherapy change — and which method was agreed with you.
- 02 Technique
Anaesthetic and surgical technique
Whether it was done under LA with sedation or a short GA, the incision and closure used, and any adjunctive procedures.
- 03 Findings
Scar, tissue quality, pelvic-floor tone
Notes on the scar released, the surrounding tissue quality, and observations about pelvic-floor tone under anaesthetic.
- 04 Impression
Recovery, no-sex window, review timing
Read this first: expected recovery, when it is safe to return to intercourse and exercise, and when your follow-up is.
Recognised by major UK insurers
Cover for a Fenton’s procedure varies by insurer and by indication — usually funded when clinically indicated for dyspareunia. We confirm cover before booking.
Frequently asked
Everything we get asked about Fenton’s procedure.
Quick answers on what it is, who it is for, cost, alternatives, and what recovery really looks like.
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What is a Fenton’s procedure?
A short surgical repair that widens a tight or scarred vaginal opening. A longitudinal cut is made through the scar at the posterior fourchette and then closed transversely — the transverse closure is what widens the entrance. It is done as a day case, usually under local anaesthetic with sedation or a short GA.
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Who is a Fenton’s procedure for?
Women with superficial dyspareunia — sharp entry pain on intercourse — caused by a tight or scarred introitus, typically after a childbirth tear, an episiotomy that healed poorly, or scarring from lichen sclerosus. It is only offered after non-surgical measures have been tried.
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Should I try other things first?
Yes. Vaginal oestrogen if you are perimenopausal or postmenopausal, dilator therapy, good lubrication, pelvic-floor physiotherapy for a hypertonic pelvic floor, and psychosexual counselling all matter. A careful assessment first is what separates a Fenton’s that works from one that disappoints.
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Could my pain be something other than a tight introitus?
It could. Vaginismus, vulvodynia and a hypertonic pelvic floor all cause pain at the entrance and feel similar to patients, but do not respond to surgery. A dedicated vulval or menopause clinic assessment — with a Q-tip test and digital examination of pelvic-floor tone — helps sort this out.
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How much does a private Fenton’s cost in the UK?
Roughly £2,000–£3,500 under LA with sedation and £2,800–£4,000 under a short GA. A more extensive perineoplasty is £3,000–£5,500. It is NHS-funded when clinically indicated. We confirm a firm figure within one working day.
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When can I have sex again?
Not before six weeks. Beyond that, be patient-guided — start with plenty of water-based lubricant, in positions that give you control, and stop if it hurts. Adjunct dilator use in the weeks before resuming intercourse often helps.
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What is the recovery like?
Day-case surgery, home the same day. Sitz baths and showers for the first two weeks, no baths or swimming, and no intercourse for six weeks. Most women are back to office work in three to five days. Full comfort with intercourse often takes three to six months, supported by physiotherapy and gentle scar massage.
Related tests
Looking for something else?
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Psychosexual counselling
COSRT-registered therapists for painful sex, vaginismus and sexual re-establishment.
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Menopause
Assessment and HRT for perimenopausal and postmenopausal symptoms.
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Endometriosis
Investigation and treatment of chronic pelvic pain and deep dyspareunia.
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All tests
Every test and procedure we arrange.
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