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If you’re like most people, you probably don’t give a lot of thought to your perineum, and in fact, may not even know what it is or what it does. However, the perineum is an important part of the female anatomy, and is often damaged during childbirth, which can cause functional issues later. At Cosmetic Gynecology and Aesthetics, we offer a surgical procedure known as a perineoplasty to repair damage to the perineum and restore functionality.

What is a Perineoplasty?

The perineum is located between the bottom of the vaginal opening and the anus, and as such, is often torn during vaginal childbirth, sometimes to the point where it requires suturing to repair. Its primary purpose is to support the pelvic floor, and if damaged, can result in urinary incontinence, vaginal looseness, dryness or irritation, and even a decrease in sexual sensation because the vaginal muscles are unable to contract properly. In serious cases, it can lead to prolapse of the bladder, uterus or rectum.

A perineoplasty is a surgical procedure designed to repair the perineum. The focus of the procedure is on the bottom of the vaginal opening, and the muscles and tissue that surround it. The surgery is an outpatient procedure that usually takes under an hour to perform. Your surgeon will make a small, V-shaped incision at the base of the vaginal opening, removing scar tissue if necessary, and suturing the underlying muscle and tissue back together, tightening the area. Perineoplasty surgery can return the area to its pre-pregnancy condition, not only with the removal of scar tissue and the tightening and rebuilding of the muscles of the perineum, but also by narrowing the entrance of the vagina.

In some cases, women may experience painful intercourse (known as dyspareunia) due to the vaginal opening being too tight, or because the perineal muscles are too tight. This is known as vaginismus, and can be a result of the involuntary contraction of the muscles of the perineum, making intercourse difficult and uncomfortable. Both issues can be resolved by a perineoplasty procedure in which skin is removed from both the front and back of the vaginal opening, which allows the vaginal muscles to loosen.

Am I a Candidate for a Perineoplasty?

A perineoplasty is typically an effective treatment to repair the perineal muscles, which can restore comfort and sensitivity to the vaginal area. Good candidates for a perineoplasty include women who:

  • Experienced tearing or had an episiotomy (a planned incision to widen the vaginal opening) during vaginal childbirth.
  • Did not heal well after childbirth, resulting in excessive scar tissue or incorrect muscle healing.
  • Experience a feeling of looseness in the vaginal area.
  • Suffer from discomfort – itching or pain.
  • Experience bowel changes or urinary incontinence.
  • Experience decreased sexual sensation and satisfaction.

While most of the women who choose to undergo a perineoplasty have developed issues following vaginal childbirth, that doesn’t mean that only women who have had children can benefit from the procedure. Pressure from excess weight, weight loss, or congenital conditions can also damage the perineum and cause vaginal laxity and other functional problems.

Recovery and Risks

Because perineoplasty surgery is an outpatient procedure, you will be able to return home the same day, and most people can go back to work within a few days. You may initially experience minor pain or bleeding, but this is normal and will resolve after the first couple of days.

Full recovery from a perineoplasty takes six (6) to eight (8) weeks. Strict adherence to your post op instructions provided by your surgeon is important for proper healing. These include:

  • Refrain from sexual activity
  • Do not use tampons
  • Refrain from strenuous activities or heavy lifting
  • Keep your incisions as clean and dry as possible
  • Drink plenty of water and increase your fiber intake to avoid constipation

If you are struggling with issues – functional or appearance – because of damage to your perineum, a perineoplasty may be the answer. Call Cosmetic Gynecology and Aesthetics today at 904-384-8023 to schedule a consultation with one of our experienced surgeons to discuss your sexual health.

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