Perineoplasty is a surgical procedure capable of restoring torn perineum muscles (the visible area located between the rectum and the vagina). If these muscles are torn, the vaginal opening becomes much wider than normal.
Most commonly, perineum damage results from episiotomies (surgical incisions made to help deliver a baby) and tearing during childbirth. However, perineum tearing may be caused by trauma or sexual intercourse. Perinealplasty is a surgical procedure for the perineum wrinkles may be caused by the above-mentioned phenomena.
Recently, Laser has been applicable to the Perineoplasty/Perinealplasty. Benefits of perineoplasty/Perinealplasty by laser include; more precision and accuracy as a result of the surgical wound control, less blood loss, less risk of vessel and tissue damage, and quicker recovery time, thus bringing about better results than using the old conventional scalpel procedure.
Perineum and Vagina
General Notes & Precautions
1) Important points to consider about the Perineoplasty/Perinealplasty
- This surgery does not go deep into the vagina but intends to repair the damage of childbirth or tearing right at the opening of the vagina (the depth of not over 5 centimeters).
- It aims to make this region appear normal by excising excess skin, loose skin tags, and suturing the underlying muscles or the perineal body closer together to give a more snug feeling in the introitus or vaginal opening. Mostly, the perineoplasty is performed together with the posterior vaginal repair.
- Like any other surgeries, this surgery has limitations and cannot absolutely ensure satisfactory results, because there are so many factors affecting the surgery’s success. In case of unexpected surgical results or complications, corrective surgery is an option, and will be discussed between you and the surgeon. If correction surgery wound occurs from the complication of the surgery, all expenses for services and treatment will no longer be charged to you. However, if the unsatisfactory results occur due to the complication from your non-compliance with the doctor’s orders, you will be charged accordingly.
- This surgery is not allowed for women with immunodeficiency. In addition, this surgery is not recommended unless you have a discussion with your spouse as this may lead to problems, and misunderstandings caused by refraining from sexual intercourse for quite a long time.
- This surgery is performed in our operating room for approximately 1 hour under Intravenous (IV) Sedation and Local Anesthesia. You have to refrain from drinking water or food for at least 6 hours prior to the procedure in order to decrease the risk of aspirating gastric contents during or after the surgery. This complication is very serious, and you need to strictly follow our recommendations. Within the day of the appointment, you should not drive yourself after the surgery in order to protect against any accidents caused by dizziness as a result of the sedation.
Third degree tear of perineum
- You should take a rest (refrain from work) and be still for at least 2-3 days after the surgery to enable the wound to heal faster. You should have little movement as possible to avoid wound disruption for 1 week after the surgery. You should refrain from some types of exercise affecting pelvic muscle movement and sexual intercourse for at least 6-8 weeks after the surgery.
2) Before the Perineoplasty/Perinealplasty
- ํYou will be invited to a pre-operative consultation room, where you will be evaluated for surgery. You will be received by a member of the nursing staff in our Center, who will make inquiries regarding your previous medical history as well as arrange for your vital signs such as temperature, respiration, blood pressure, and pulse. In case of existing diseases or drug allergies, please inform the medical staff before the consultation. You should prepare and take with you any pills or treatment medications, you are currently taking.
- You can possibly have the surgery done on the day of your consultation depending on the availability of Dr. Vitasna’s schedule. Otherwise, you may book for a possible surgery on the day of your consultation. This you may do through online pre-consultation and arrangement. It is best to undergo the surgery after your period. It is not advisable to do the surgery just before the period starts or during the period.
- A staff nurse will usher you to a treatment room, where Dr. Vitasna will investigate your health history, and conduct both a general check-up and internal check-up. In case you have vaginal fungal or bacterial infection, you should completely treat it before the surgery to avoid wound infection after the surgery.
- After the examination and assessment, you will discuss with Dr. Vitasna about your expectations and concerns. She will then explain to you about the methods (or techniques), processes of the surgery, some potential post-operative risks and complications prior to decision-making. You may also be asked if you have any allergies or any condition that wouldn’t make you a good candidate for the surgery as well as other additional inquiries.
- After you have chosen the best alternative for your case, prices and quotes will be written down with you. —This ends your consultation.
3) The cost of the Perineoplasty/Perinealplasty
The cost of the surgery will include professional fees for the anesthesiologist and the surgeon, all the instruments, home medications, and medicines used for the surgery as well. Fees for laboratory work-up for other existing diseases that you may have, and the professional fees for the anesthesiologist and the surgeon for corrective surgery are not included in the package.
The Processes of the Perineoplasty/Perinealplasty
1) On appointment day you plan to have the Perineoplasty/Perinealplasty
- You have to refrain from drinking water or food for at least 6 hours prior to the surgery. In addition, it is advisable to have a bath or perhaps a shower before you come into the hospital. You may need to bring along with you loosely fitting daytime clothing, personal hygiene stuff, loose fitting underwear, and sanitary pads.
- Before you go through the pre-operative processes, if you have more questions you will meet Dr. Vitasna for any additional information. In case of uncertainty, doubt and worry, or for being uncomfortable for any reason, you should postpone the surgery.
- If you are a good candidate for the surgery, our medical staff will assess your vital signs, help you sign, and review the proper consent forms, which give us permission to perform surgery on you. Then a staff nurse will review the post-operative care instructions, which you need to do after the surgery and will guide you through the process of payment.
- If you are wearing nail polish or makeup, you may be asked to remove it. Contact lenses are to be removed as well as glasses and dentures. Jewelries are also to be taken out. Should you be unable to remove some piece of jewelry, a protective tape will be placed over it.
- After all these have been done, a staff member will accompany you to the operating theater, and will hand you over the care of the anesthetic team. A staff nurse is going to check your information (name, birth date) and your vital signs, assist you to change into a gown, and provide you with an identity wristband.
- You will be directed to the anesthesiologist, who will administer the anesthesia during the surgery. Please tell him/her about your allergies to medications, your medical history, dental treatments, previous surgeries you have had, and any family history with anesthesia problems.—Once everything is complete and in order, a nurse will take you to one of the operating rooms.
2) During the Perineoplasty/Perinealplasty Surgery
- While you are sleeping, Dr. Vitasna will remove the excess perineum tissues. Thus, the posterior vaginal opening tissues are separated forming a wedge shape or an inverted V shape.
- Afterwards, Dr. Vitasna will suture both of the wound edges or two sides of the V shape with slow absorbable suture. Dr. Vitasna will do the suturing and tightening along the entire length of the posterior vaginal opening. The suturing is done alternatively with 2 or 3 layers to avoid post-operative bleeding.
Before the Perineoplasty
After the Perineoplasty
The rate of complications after the Perineoplasty/Perinealplasty is low, especially when laser is utilized by an experienced surgeon, and you carefully and religiously follow our post-op policies. In the unlikely event of a post-op complication, you should immediately see Dr. Vitasna for early examination and treatment and prevent worsening of the complication.