The perineum is the area between the vaginal introitus and the anus (back passage). During childbirth, tears can occur in the perineum. Sometimes a cut (episiotomy) is made in the perineum deliberately to widen the introitus and facilitate childbirth. These tears/cuts when badly healed, can give rise to painful scars, dyspareunia and unwanted aesthetic appearance. There may be gradual relaxation of the perineal muscles, loss of firmness of the skin around the vagina with an increase in the vaginal diameter.
Perineoplasty involves the cosmetic surgical reconstruction of the perineum. It aims to remove any malformed granulation tissue, excess, relaxed or folded skin. It can successfully tighten and strengthen the perineal area. The improved self-confidence engendered by the surgery may well translate into improvements in other areas such as intimacy. However, it must be emphasized that perineoplasty is not a treatment for sexual dysfunction.
Prior to having this procedure done, you will be seen for an initial consultation by either Professor Manyonda or Miss Gupta. During this consultation, one of us will go through your wishes and expectations from the procedure and your suitability for it. You will be examined, and depending on the findings, we will make our recommendation. Sometimes we might recommend a combined procedure like perineoplasty and surgical/non-surgical vaginal tightening. At other times we might advise against surgery. Each situation is different.
While perineoplasty can be performed under local anaesthesia and/or sedation, our experience is that in the majority of instances it is better than the patient is asleep (general anaesthesia) to allow complete relaxation, as the procedure could last up to two hours or longer.
A diamond shaped wedge of tissue is removed with the apex in the posterior lower third of the vagina and the nadir on the perineum superior to the anus. The wings of the diamond extend laterally to the hymenal ring. Re-approximation of the levator ani muscles causes an elevated perineum and a strengthened perineal body. Vaginal skin and the perineal skin are both repaired by absorbable sutures.
We recommend that you stay at home for 7 days. We will give you medical dressing and also local/topical antibiotic cream to apply. You will be given adequate pain relief as well as laxatives to keep your stool soft. You must take care of the local hygiene and avoid soap and rubbing the area. Always wash with abundant warm water and keep the area dry. Avoid pilates, yoga, lifting heavy weight and laser epilation for a minimum of 1 month. Avoid intercourse for 2 months. You will be given a detailed post-op instructions leaflet, which can also be read on this website – please refer to menu bar.
You will be reviewed at 1 week and again at 6 weeks following your operation.
