What is the Perineum?
The perineum is the area of tissue between the vagina and the rectum. Childbirth can cause tearing and scarring of the perineal tissue. Oftentimes, the healing process of these tears leads to uneven scarring and disfiguration of the perineum. This condition often results in vaginal looseness.
Perineal surgery repairs the damage and resurfaces the tissue in order to return the area to its pre-pregnancy state. The surgical procedure also rebuilds and tightens muscles. The entrance of the vagina will be narrowed, providing the additional benefit of vaginal tightness for intercourse.
Perineal repair is often performed in conjunction with vaginoplasty, but it may also be performed as a single surgery.
What is the Perineoplasty Procedure?
Perineoplasty is an outpatient surgery and is performed under mild sedation with local anesthesia. The procedure usually takes between 30 and 45 minutes. During this time, Dr. Ghozland will make a V-shaped incision with a fractional CO2 pixel laser or Ellman Surgitron, which utilizes radiofrequency, in the posterior wall of the vagina. Any existing scar tissue will be removed. The underlying muscle and tissue will then be brought back together, and the incision will be closed with dissolvable stitches.
The CO2 laser or Ellman Surgitron both provide extremely precise incisions with very little to no thermal damage and good hematology.
When Can a Perineal Repair Surgery be Performed?
A perineoplasty is usually performed during a vaginoplasty. However, it may also be performed by itself. The perineoplasty procedure is performed pain-free environment in Dr. Ghozland’s office. After a recovery time of about an hour, the patient may return home.
Who is a Candidate for Perineoplasty?
Women who have given birth vaginally and are experiencing vaginal looseness or itching, decreased sexual sensation or changes in bowel habits are the most common candidates for this procedure.
However, a woman doesn’t have to have experienced childbirth to suffer from these symptoms; the pressure of excess weight can also over-stretch and damage the structures of the perineum. Stretched muscles and tissue can lead to a feeling of looseness in the vagina and may contribute to vaginal flatus and decreased sexual satisfaction.
Recovery After a Perineoplasty
Most patients return to work within a few days after their Perineoplasty procedure. Pain is managed by over-the-counter or prescription medication. In the first few days, some minor bleeding is not uncommon and wearing a sanitary pad is recommended. The incision should be kept clean and dry. Stitches usually dissolve in about two weeks. Patients are advised to drink plenty of water and increase fiber intake to avoid constipation. Normal activities may be resumed in four weeks. Patients should abstain from sexual intercourse for six weeks.
Are There Any Risks With Perineoplasty?
The risks associated with this procedure are primarily infection and bleeding. Antibiotics can be prescribed for an infection. With today’s procedure techniques, bleeding is kept to a minimum. Another less serious but more common risk is constipation. Increasing fiber and water intake will usually take care of this, but a stool softener may also be used.
This simple outpatient procedure restores the normal function and appearance of the perineum giving women renewed self-confidence and more satisfying sexual intimacy.