Perineorrhaphy

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Perineorrhaphy, also called ‘perineoplasty’  is the process of reconstructing the vaginal opening by tightening the weakened and relaxed walls of the perineum, that is, tightening the opening of the vagina, which might have been relaxed, stretched extremely or damaged due to childbirth, sexual intercourse, obesity, or inadequate innervation.

Perineorrhaphy corrects perineal relaxation.

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Perineorrhaphy

Perineorrhaphy could occur as a result of childbirth, obesity, inadequate innervation, sexual penetration e.t.c. The area between the vagina and the rectum is called the perineum. Sometimes, due to certain reasons or activities, the perineum may relax, slacken, or get damaged. However, with the advance in medicine, surgical procedures are now possible to tighten the area when such happens. What is Perineal Relaxation? Perineal relaxation is a condition in which the opening to the vagina is stretched and relaxed. The muscles of the perineum weaken, resulting in an increased caliber of the vaginal opening. Some women describe this as a feeling of “vaginal looseness” or feel that there is decreased sensation during intercourse. Surgery Procedure and Process Before Surgery, Make sure to consult with your doctor, who will review your medical history and deem you fit for the surgery. You will be advised to stay away from medications, smoking, and alcohol for 2 to 3 weeks before the surgery, as they can slow your rate of healing. In Surgery, You will be administered anesthesia, local or general, based on the effect you want. The surgeon makes a V-shaped incision starting from the top of the vaginal floor, cutting through the vaginal mucosa and the perineum. The incision is continued laterally on both sides of the hymenal ring and vaginal opening and ends just above the anal area. The skin within this diamond-shaped incision is then carefully peeled back and removed, as needed. For the reconstruction process, the muscles are carefully put back together along the vaginal floor. The fascia is also moved to cover the reconstructed muscles, cutting away any excess skin and other tissues. Once the desired tightness or looseness is achieved, the surgeon suture the surgical site neatly and precisely. After Surgery, You will be transferred to the ICU to recover and will be administered pain relievers to ease your pains. You will be required to stay in the hospital for a few days to be monitored. Possible Complications Perineorrhaphy is commonly done among women, with a high success rate. However, in a few cases, complications may arise. Some include:
  • Bleeding; which may recover blood transfusion
  • Post-operative infection that may require antibiotic therapy.
  • Bladder infections (cystitis)
  • Pain or discomfort with intercourse.
  • Damage to the rectum during surgery
  • Infections that may require antibiotic therapy
  • Inflammation and swelling at the surgical site
  • Abnormal discharge with an offensive smell
  • Constipation
  • Leaking urine and feces.
Recovery Rate The recovery rate of perineorrhaphy depends on certain factors such as; the extent of the tear, the woman’s unique structure, and how deep the tear is. At first, recovery could be quite painful and uncomfortable especially while sitting, walking, urinating, bowel movements at least for a week. Within 4 – 6 weeks, the pains should have reduced. While recovering, keep to the following guidelines:
  • Do not participate in strenuous activities.
  • Avoid any form of sexual intercourse until you are fully recovered.
  • Take out bandages and wipe the area clean with a warm water-soaked towel every day
  • Sanitize the area and change the bandages over the incision every day.
  • Make regular visits to your surgeon for a checkup.

Symptoms

A woman who experienced a severe tear in the vaginal as a result of childbirth or other strenuous activities.

Causes

A perineoplasty (or perineorrhaphy) aims to make the perineum more appealing by excising excess skin, removing skin tags, and reapproximating the underlying muscles or the perineal to provide a reduction in the introitus or vaginal opening.

Women may report a feeling of physical looseness which may also be associated with decreased sexual satisfaction when compared to satisfaction before damage to the perineum. This procedure almost always accompanies vaginoplasty.

FAQ

1. How long does it take to recover?

Recovery may take up to 4-6 weeks. You might experience pains during the beginning period of recovery especially during bowel movements but with time, the pains.

2. How do you poop after a rectocele surgery?

After surgery, bowel movement at first might be painful. Here are certain helpful tips for your bowel movement

  • Try sitting on the seat of the toilet properly
  • Let your feet be flat on the floor
  • Lean forward and rest your hands on your thigh
  • Let your lower back be kept in an inward curve during emptying.

3. How long does it take for the stitches to dissolve after surgery?

The many stitches in the vaginal may cause you to experience bleeding but the stitches dissolve On their own after approximately 4-8 weeks.

4. How soon can I drive after the surgery?

This might take 2-4 weeks after surgery, and sometimes up till 6 weeks. Don’t try driving till you can comfortably sit properly without discomfort and you can safely perform an emergency stop.

5. Is walking well after the surgery?

Walking after the surgery is good and beneficial as it promotes physical recovery, reduces the risk of post-surgery complications, aids breathing, promotes circulation, and prevents clotting in the deep veins of your leg.

6. How successful is perineorrhaphy surgery?

There is an 80-90% success rate for posterior vaginal wall repair.

7. When can I return to my usual routine?

First, you should avoid situations where excessive pressure is placed on the repair. You should wait for at least six weeks before attempting sexual intercourse.