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. Repairing and restoration of the loose, aging or injured perineum is taken care of through the surgery of Perineoplasty.It is helpful for those women who don’t heal efficiently after a vaginal delivery or experience ugly scarring. They may have incontinence issues or difficulty in coitus for both partners.
Two variants of Perineoplasty :
Tightening Perineal muscles & vagina
Loosening the perineal muscles
What is the technique of Tightening Perineoplasty surgery?
Perineoplasty or Perineorrhaphy is a surgical procedure which corrects the defect or damage caused to a woman’s vagina, anus or perineum. This method is sometimes combined with a vaginoplasty and is designed 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 with scarred perineum, vaginal laxity, and they wish to repair and improve the sexual function and aesthetic appearance of the perineum after labor.
Complete Perineal Tear Repair
In India, deliveries in rural areas or by untrained dais may result in complete perineal tear and result in recto vaginal fistulas. For such patients, Complete Perineal tear repair is an ideal procedure, where we repair anal mucosa, form internal and external anal sphincter accompanied by formation of Perineal body so as to restore completely functional vagina and anus.
The Complete perineal tear repair is technically difficult procedure and performed at very few places. It demands well trained cosmetic gynecologist & plastic surgeon and it is routinely performed at our center in Jaipur. Hence, we receive referral cases too for the same.
What is the technique of Loosening Perineoplasty Surgery?
The woman who experiences painful sexual intercourse (dyspareunia) due to involuntary contraction of posterior vaginal and perineal muscles are said to be having Vaginismus. These patients face difficulty in pentetration as the posterior vaginal and perineal muscles undergo sudden involuntary contraction during penetration. This results in embarrassment for both the partners and marital relations are difficult to consummate. They are often treated by conservative measures like kegel exercise, training with a stent, using lubricating gels prior to coitus and psychological counseling etc.
In the refractory cases of vaginismus, where conservative measures fail, we provide the loosening variant of perineoplasty that loosens the over tight vaginal opening. A triangular skin is excised with its apex towards anus, tight musculature released and excess vaginal mucosa is removed. This adjustment of perineal musculature increases the size of vaginal opening.
Recovery takes about 4-6 weeks after which vagina becomes totally functional.
If Perineoplasty surgical technique is adequately performed by a well experienced cosmetic gynecologist it can bring a lot of relief to the agony of patients and they can share positive intimacy!!