We're Certain You Haven't Heard of This Before: Perineoplasty!

Genital Rejuvenation

By Emel Gerdaneri • Medical review by Evrim Aksoy, MD

Obstetrics and Gynecology Specialist Evrim Aksoy, MD Special Interview

We're Certain You Haven't Heard of This Before: Perineoplasty!

Medical terms often confuse us, and we might even struggle to articulate them. Yet today, we're addressing an issue many women who have given birth naturally face.

The treatment is called perineoplasty, which can be thought of as the repair of the perineal area. For more detailed information, we asked our questions to Obstetrician and Gynecologist Dr. Evrim Aksoy:

Evrim Aksoy, MD
 

Let's Start from the Beginning, What Is the Perineum and What Exactly Is Its Function?

perineThe perineum is the area between the anus and the vagina. Though small, the perineum serves an important function, such as providing structural support for many surrounding organs and containing muscles that play a significant role in vaginal tightening and relaxation.

So, What Can Lead to Perineal Damage Requiring Perineoplasty?

We may encounter perineal damage in situations like childbirth, obesity, and excessive weight loss, among others.

Could You Evaluate Each of Them?

Childbirth

childbirth
Giving birth vaginally, especially in difficult labor, is the most common cause of perineal damage.

Even a straightforward birth can cause physical trauma to vaginal and perineal muscles. Sometimes, to facilitate the baby's delivery, we make a cut in the perineum, called an episiotomy. If we don't make this incision, waiting for a tear in this area naturally during delivery could cause more damage.

If this incision is made by a less experienced doctor or if the stitching is done carelessly, it may lead to inappropriate healing of tissues, muscles, and the perineum.

As a result, the patient may have a severe scar, causing pain and discomfort. Multiple births can exacerbate these problems.

During a perineoplasty operation, we can reopen the previously stitched area, re-stitch it correctly, rectify it, and ensure proper healing.

Obesity

obesityExcessive weight can strain not only the perineum but also the supporting structures of the entire body.

It can also stretch the muscles, causing them to lose their elasticity, similar to how a mattress gradually loses support and becomes concave where your body weight rests on it each night over time.

Excessive Weight Loss

weight lossWe've all seen the sagging and excess skin damage in individuals who have rapidly slimmed down due to illness or obesity surgery.

Even if the weight pressure diminishes, it can still cause permanent sagging of the perineum and other muscles. Think of the analogy of the mattress I mentioned earlier.

It might temporarily regain its former shape during the day, but over a few years, the indentations and depressions become permanent.

Now, Let's Move to Our Main Question, What Is Perineoplasty?

perineoplastyPerineoplasty is a surgical procedure that focuses on the deformities, defects, and damages of a woman's anus and vagina.

The surgery specifically removes scar tissue, protrusions, and undesired skin, then tightens or loosens perineal muscles and the vagina.

Another benefit of perineoplasty is that making these adjustments also serves to restore a woman's confidence and potentially enhance her physical sexual pleasure levels.

What Else Can Perineoplasty Treat?

genitalI can summarize as follows:

Vaginal itching: Issues in this area can trigger yeast formation

Vaginal looseness: The laxity of the vaginal opening that can lead to decreased sexual sensation

Vaginismus: Involuntary contractions of the vagina during attempts at intercourse

Vulvar vestibulitis: Intense pain during penile or tampon entry

Incontinence: Involuntary urine leakage

Intraoital vaginal stenosis: Vaginal narrowing often caused by cancer treatments

Dyspareunia: Painful intercourse due to a small vaginal opening

Cystocele: Protrusion of the bladder into the vagina

Rectocele: Protrusion of the rectum into the vagina

Aesthetic enhancement: Repair of loose and sagging tissue or protrusions to give the area a more appealing visual appearance

How Is Perineoplasty Performed and What Is the Recovery Process Like?

after perineoplastyPerineoplasty is a treatment procedure that typically lasts about an hour under general or local anesthesia. Hospitalization is rarely required. A 'V-shaped incision is made in the rear vaginal wall.

Scar tissue, protrusions, and other damages are corrected. Depending on the purpose of the surgery, muscles are either tightened or loosened to rectify the issue and carefully sutured. After a brief recovery period, the patient is allowed to return home.

During the recovery period, sexual intercourse should be avoided for six weeks. I also recommend avoiding strenuous activities like cycling, horse riding, heavy lifting, or stretching during this time.

The use of tampons should be avoided. Most of my patients can return to work after a few days. Pain and discomfort are generally minimal to moderate and can be managed with painkillers.

There might be slight bleeding and discharge, which is normal. As a result of anesthesia, there might be some dizziness or nausea for a day or two, but this typically fades after forty-eight hours.

The incision should be kept clean and dry. The stitches typically dissolve on their own within two weeks. It's important to drink plenty of water and increase fiber intake during this time to prevent constipation.

Lastly, Is There Anything Else You'd Like to Add?

perinaChildbirth can cause significant trauma and physical changes in the body, something women have historically accepted as part of the reproductive process from ancient times.

However, today there are procedures available that can almost restore your body to its pre-pregnancy state. There's no need to suffer silently.

If you have any of the symptoms I mentioned earlier, you can take action to alleviate this pain or embarrassment."


Written on 25/10/2021

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Last Update: 08/01/2024

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