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Perineoplasty

- Information for patients (Pelvic Health Care)

Prepared by:
Prof. Ajay Rane, Consultant Urogynaecologist MBBS MD MRCOG FRCS FRANZCOG CU
Audrey Corstiaans ,Urogynaecology Nurse

Updated: July 2007


What is Perineoplasty?

This is a repair of the tissues between the vagina and anus that has been damaged or torn during childbirth. This usually causes vaginal looseness and vaginal flatus. This "plastic surgery" will restore your vaginal opening to near pre pregnancy condition.

How is this done?
  • This procedure is carried out under a general anaesthesia and usually as a day patient in hospital.
  • There is an incision made at the introitus (vaginal opening) and the tissues are bought back together and stitched in place with dissolvable sutures that will last for up to 4-6 weeks.
Results
  • This procedure will decrease the feeling of vaginal looseness and improve sexual function.
  • Weight reduction if overweight, reducing or quitting smoking, improving pelvic muscle tone by doing pelvic floor exercises and continuing these regularly after the operation will help to ensure that the operation is a success.
Complications
  • As with any operation there can be infection of the wound but this is usually treatable with antibiotics.
  • There is also a small risk of bleeding which is treatable. Anaesthesia is not without risks.
Hospitalisation

This procedure is usually done as a day case where you come in the morning and are discharged later the same day. Do bring some pads, as some bleeding will occur.

Recovery When you go home you must not lift heavy objects or do strenuous work for about four weeks. Avoid intercourse for the same period. You can return to work usually in 1 week.

Afterwards
  • You will be seen six to eight weeks after the operation. If everything is well the success of our operation should be permanent. You will be given a follow up appointment 10 t0 12 weeks after surgery; if you have any queries during this time please contact the Hospital.
  • It is important to check with your insurance company, re driving your car as each company has different policies on driving and surgery.
  • Your incisions just need to be kept clean and dry. The stitches are dissolvable and may take four to six weeks to completely dissolve.
Post Operative Instructions

Pain should be relieved with Panadol or Panadeine (remember if you take Panadeine, this increases the risk of constipation so ensure you have an adequate intake of fibre and fluids in your diet). Some bleeding may occur during the first week or so, this is the stitch coming away. This is quite normal providing it is 'pinky' coloured discharge. (If your loss becomes dark, clots or an odour develops then you must contact your local GP)

Do not use tampons, pads are better
Do not drive an automatic car for 1 week*
Do not make a bed for 2 weeks
Do not hang out washing for 4 weeks
Do not use Vaginal Oestrogens for 4 weeks
Do not mop or vaccum for 6 weeks
Do not lift anything over 4kg for 6 weeks
Do not have sexual intercourse for 6 weeks

* It is important to check with your insurance company, re driving your car as each company has different policies on driving and surgery.

The guidelines are minimum time before recommencing these activities.

- Remember to rest, if you are tired and uncomfortable you have been doing too much and need to slow down.
- Remember when emptying your bladder, sit on the toilet, feet flat and lean forwards.
- Drink 6 - 8 glasses of fluid per day; limit your caffeinated drinks to 3 per day.
- Ensure your fibre intake is 30 grams per day.
- If constipation is a problem, Lactulose, which you can buy from the chemist or another stool softener should be used.

Contact your G.P or your local hospital if you experience any of the following

- Pain that is not relieved by Panadol or Panadeine
- Burning or difficulty passing urine
- Redness or sign of infection in wound

Smelly or offensive vaginal discharge
- You develop a temperature or become unwell
- You have severe pain or bleeding
- You experience heavy vaginal bleeding or clotting

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