▁the ▁case ▁of ▁cancer , ▁sometimes ▁the ▁dise ased ▁areas ▁are ▁surg ically ▁removed . ▁Fem ales ▁may ▁under go ▁v agine ct omy ▁or ▁vul ve ct omy ▁( to ▁the ▁v ag ina ▁and ▁vul va , ▁respectively ), ▁while ▁males ▁may ▁under go ▁pen ect omy ▁or ▁orch ie ct omy ▁( rem oval ▁of ▁the ▁pen is ▁and ▁test icles , ▁respectively ). ▁Re construct ive ▁surg ery ▁may ▁be ▁performed ▁to ▁restore ▁what ▁was ▁lost , ▁often ▁with ▁techniques ▁similar ▁to ▁those ▁used ▁in ▁sex ▁re ass ignment ▁surg ery . ▁ ▁During ▁child b irth , ▁an ▁epis iot omy ▁( cut ting ▁part ▁of ▁the ▁t issue ▁between ▁the ▁v ag ina ▁and ▁the ▁an us ) ▁is ▁sometimes ▁performed ▁to ▁increase ▁the ▁amount ▁of ▁space ▁through ▁which ▁the ▁baby ▁may ▁emer ge . ▁Adv oc ates ▁of ▁natural ▁child b irth ▁and ▁un ass isted ▁birth ▁state ▁that ▁this ▁inter vention ▁is ▁often ▁performed ▁without ▁medical ▁necessity , ▁with ▁significant ▁damage ▁to ▁the ▁person ▁giving ▁birth . ▁ ▁H ymen ot omy ▁is ▁the ▁surg ical ▁per for ation ▁of ▁an ▁imper for ate ▁h ymen . ▁It ▁may ▁be ▁performed ▁to ▁allow ▁men stru ation ▁to ▁occur . ▁An ▁adult ▁individual ▁may ▁opt ▁for ▁increasing ▁the ▁size ▁of ▁her ▁h ymen al ▁opening , ▁or ▁removal ▁of ▁the ▁h ymen ▁altogether , ▁to ▁facil itate ▁sexual ▁pen etr ation ▁of ▁her ▁v ag ina . ▁ ▁The ▁world ' s ▁first ▁pen is ▁reduction