What’s the Word for Suturing the Vulva?

When it comes to women’s health, there are different procedures done to restore and maintain their reproductive system’s health. Vaginal issues concerning the vulva may occur due to various factors, including childbirth, injury, infections, and genetic abnormalities.

In many female health procedures, suturing the vulva is necessary. The right medical term for this procedure is Perineorrhaphy.

Perineorrhaphy: What is it?

Perineorrhaphy is a surgery that aims to correct any damage to the perineum or the area between the vaginal opening and the anus. The perineum can either tear or stretch during vaginal deliveries or any other strenuous activities that can cause tissue damage.

Perineorrhaphy can be modified based on the extent of the damage sustained by the perineum. It can be either partial or complete, and it involves suturing the perineum muscle to restore its integrity and improve its strength.

The Reasons for Perineorrhaphy

Perineorrhaphy is a procedure that can correct various problems of the perineum due to different causes, including:

  • Tearing of the perineum during childbirth or other strenuous activities
  • Stretching of the perineum muscle
  • Tear in the underlying muscle fascia
  • Herniation of the perineal body

Perineum Tear during Childbirth

Women who delivered their babies vaginally may experience perineum tearing. In this case, the muscles around the vaginal opening tear, and the injury can extend to the anus. The degree of tearing can either be severe or mild, depending on the size of the baby’s head and the duration of delivery.

Perineorrhaphy can repair this tear by suturing the perineum muscles to restore their function.

Perineal Stretching

Perineal stretching occurs when the muscle and the tissue in the perineal area become stretched out, making it feel loose or weak. The weakening of the perineal muscle can lead to urinary incontinence or decreased sexual function.

Perineorrhaphy can tighten and restore the tone of the perineal muscles, reducing the risk of urinary incontinence and improving sexual function.

Tear of the Underlying Muscle Fascia

Perineal body injury during childbirth or at any other time can tear the underlying muscle fascia that connects the anus and the vagina. This condition can lead to anal incontinence, difficulty in passing stool or urine, or pain during intercourse.

Perineorrhaphy can repair the torn muscle fascia and restore its normal function.

Herniation of the Perineal Body

Herniation of the perineal body is a condition in which the perineal muscle protrudes, causing discomfort, pain, or trouble with emptying the bowels or bladder. The herniation happens as a result of injury to the perineal area during childbirth or any other strenuous activity.

Perineorrhaphy can repair the herniation and restore the normal function of the perineal muscle.

Perineorrhaphy Procedure

The perineorrhaphy procedure is generally done under local anesthesia or general anesthesia. The procedure includes the following steps:

  • Initial examination or inspection of the perineum to determine the extent of the injury and the degree of tissue damage
  • Cleaning of the perineal area with an antiseptic solution and sterilizing the area with antibacterial agents
  • Administering local anesthesia or general anesthesia, depending on the patient’s condition and preference
  • Injection of a local anesthetic agent to the perineal muscles to numb the area
  • Using stitches to close the perineum tear or holes in the muscle fascia

The procedure usually takes 30 minutes to complete, but the time frame can vary depending on the extent of the repair.

Post-Surgery Care

After the procedure, the patient needs to take proper care of the area to ensure it heals well. Here are some things to consider:

  • Take any prescribed medications as instructed by the physician to manage pain or reduce swelling
  • Avoid any heavy lifting or strenuous work for a few days until the wound heals
  • Avoid sexual intercourse for at least six weeks or until the surgical incision heals completely
  • Use a sitz bath or mild soaps to clean the perineal area daily
  • Wear loose clothes to avoid irritating the perineal area

Risks Associated with Perineorrhaphy

Like all surgeries, perineorrhaphy has its risks. Some of the complications may include:

  • Bleeding
  • Infection
  • Scarring
  • Discomfort or pain in the perineum
  • Incontinence

However, the procedure is generally safe, and the surgeon will discuss the possible risks with the patient before proceeding with the surgery.

Conclusion

Perineorrhaphy is a procedure that can restore the function and strength of the perineum area. The procedure can correct perineum tears, fascia tearing, herniation, or stretching. After the procedure, the patient must follow the physician’s instructions to ensure the wound heals well.

FAQ

  • What is Perineorrhaphy?

    Perineorrhaphy is a surgery that aims to correct any damage to the perineum or the area between the vaginal opening and the anus.

  • What are the reasons for Perineorrhaphy?

    Perineorrhaphy can correct various problems of the perineum due to different causes, including tearing of the perineum during childbirth, perineal stretching, tear in the underlying muscle fascia, and herniation of the perineal body.

  • What happens during Perineorrhaphy Procedure?

    The perineorrhaphy procedure is generally done under local anesthesia or general anesthesia, and it includes initial examination or inspection of the perineum, cleaning of the perineal area, and closing of the perineum tear or holes in the muscle fascia using stitches.

  • What should I do after Perineorrhaphy?

    After the procedure, the patient needs to take proper care of the area to ensure it heals well. The physician may prescribe medication to manage pain or swelling, avoid strenuous activity, and maintain proper hygiene by cleaning the perineal area regularly.

  • What are the risks associated with Perineorrhaphy?

    The risks associated with perineorrhaphy include bleeding, infection, scarring, discomfort, pain, or incontinence, but generally, the surgery is safe, and the physician will discuss the possible risks before the surgery.

References:

  • MacKenzie IZ. Perineal repair: episiotomy and the second stage of labor. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA, 2021.
  • Osman N, Abdelrahman MY, Ali ST. Perineal reconstructive surgery: Posterior colporrhaphy with perineorrhaphy. Arch Gynecol Obstet. 2015 Sep;292(3):493-8.
  • Awad SS. Perineorrhaphy. 2020 Nov 13. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–.

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