Procedure | Surgical
Perineoplasty
The perineum—the area of skin tissue that extends from the vagina to the anus—is often injured from an episiotomy or tearing during childbirth. Thus, Perineoplasty reshapes and tightens the area between the vaginal opening and the anus. Perineoplasty is sometimes combined with vaginoplasty to tighten the posterior muscles and remove excess perineal skin and distal vaginal mucosa. The procedure is known to eliminate or reduce the lax feeling of the area while improving the look and function of the genitalia. This option is suggested for patients without vaginal laxity, but that wish to repair and improve the sexual function and aesthetic appearance of the perineum after labor. A widened or scarred perineum can also have a negative affect on sexual activity and future pregnancies.
Preparation:
• Taking days off work.
• You will also be instructed to stop taking aspirin, Ibuprofen, and other anti-inflammatory medications (NSAIDS).
• If you smoke, you will be asked to stop smoking at least two weeks before and after the procedure to reduce the risk of serious complications.
• Wearing loosest panties as much as possible.
• Avoid stressful activities like heavy exercises 1 week before.
• Postpone the procedure date if you have any symptomes of menstruation 2 days before the procedure.
• Eat healthy, and drink plenty of water in the days leading up to the procedure.
A perineoplasty typically only requires local anesthesia and is done on an outpatient basis. The patient will be positioned on a table with the legs spread. The incisions done during a perineoplasty will vary depending on the needs. The procedure may be performed with either a traditional scalpel or with lasers. Typically, incisions will be made in a V-shaped pattern within the vaginal mucosa. Excess skin and any scar tissue is excised.
Internal and external closure of the vaginal mucous and perineal muscles are performed to achieve a tighter appearance and function of the perineum.
Patients can expect to return to work after 1 week.
The incision must be kept clean and dry. Stitches will dissolve by themselves in about two weeks.
The material (s) used is the suture which dissolves slowly (within 6-8 weeks).
After the surgery, you may have all kinds of food, with the exceptions of alcoholic drinks, pickled food, and smoking for about 2 weeks.
Patients are cautioned to refrain from sexual intercourse for about 6 weeks.
It is recommended that any strenuous activity such a bicycling, horseback riding, heavy lifting, or stretching be avoided during this time as well.
Tampons should not be used.
It is important to drink lots of water and increase fiber intake during this time to avoid constipation.
Results are noticeable immediately.
After the first 2 weeks to 4 weeks after the surgery, the surgical wound is expected to heal appropriately, you may start your usual activities gradually. After 4 weeks of the surgery, you may do your usual activities. Relaxing exercises and lifting light weights are permitted. However, you should refrain from running, soaking in the bathtub, swimming, heavy lifting, cycling, other heavy activities, and sexual intercourse for 6-8 weeks after the surgery.
Possible complications may include:
Excessive bleeding
Signs of infection
Constipation not relieved through fiber intake
Vaginal discharge accompanied by a foul odor.
