Why is this procedure done?
The muscle between a females vagina and anus is the perineum. The perineum supports the structures inside the pelvis including the vagina, rectum, and bladder. ‚
Sometimes, when you have a baby, there is a tear or cut to the perineum. Trauma can also cause an injury to this area. The procedure to repair an injured or cut perineum is an episiorrhaphy. ‚
What will the results be?
Your doctor will stitch your perineum together. Your doctor will repair any torn or cut tissues. Your perineum will heal faster. ‚
What happens before the procedure?
- Your doctor will take your history and do an exam. Talk to your doctor about:
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some examples are Coumadin, ibuprofen, Aleve (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about all of your drugs.
What happens during the procedure?
- You will lie on your back with your feet in foot holders. The staff may shave your genital area. You may have an IV line in your arm to give you fluids and drugs.
- The doctor will clean your vagina with an antiseptic. If your vaginal area is not already numb, the doctor will give you some numbing drugs in the walls of the vagina.
- Your doctor will close any open blood vessels. Your doctor will stitch the muscles together then close the skin with a few more stitches.
- Your doctor may leave a roll of gauze inside your vagina to help stop bleeding.
- The procedure takes about 20 to 30 minutes.
What happens after the procedure?
- You will go to the Recovery Room and the staff will watch you closely. You may have to stay in the hospital for 1 to 2 days.
- You may have discomfort and numbness after the procedure. You may have more pain when the anesthesia wears off.
What care is needed at home?
- Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what you need to do.
- Your doctor will give you drugs for pain and to prevent infection. Take the drugs as ordered by your doctor.
- You may have bloody discharge coming from the wound. You may wear a sanitary pad. Change the pad when soaked. Ask your doctor before using tampons.
- You may wash your vagina with mild soap and water. Do not pull anything you feel coming out of your vagina. It might be a stitch used to close your wound.
- Passing urine may be painful. Your doctor will give you pain relievers. Pour warm water over your vagina while you pass urine.
- Avoid straining to pass urine or bowel movements.
- Take a sitz bath 3 to 4 times each day. Sit in 2 to 3 inches of warm water in the tub for 10 to 15 minutes each time. Carefully wipe your bottom afterwards.
- Place an ice pack or a bag of frozen peas wrapped in a towel over the painful part. Never put ice right on the skin. Do not leave the ice on more than 10 to 15 minutes at a time.
- Gently press a clean pad against your wound when you bear down for a bowel movement.
- Use a pillow or padded ring when you sit to make you comfortable.
What follow-up care is needed?
Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep your visits. ‚
What lifestyle changes are needed?
- Avoid hard activities and heavy lifting for 6 weeks. You may slowly increase your activity. Ask your doctor about the right amount of activity for you.
- You may have to delay having sex. Wait for 1 to 3 months or ask your doctor when you can have sex.
- Eat a high fiber diet to prevent hard and dry stools.
- You may need to use lubricants during sex if there is still pain, even after the wound heals.
What problems could happen?
- Bleeding
- Infection
- Swelling
- Scarring
- Pain during sex
- Pain or other problems when passing urine
When do I need to call the doctor?
- Signs of infection such as a fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills, pain with passing urine, wound that does not heal, or anal itching or pain.
- Signs of wound infection such as swelling, redness, warmth around the wound; too much pain when touched; yellowish, greenish, or bloody discharge; foul smell coming from the cut site; cut site opens up.
- Too much bloody vaginal discharge
- Pain not relieved by drugs
- Urine seems to be coming from another opening
Where can I learn more?
NHS Choices ‚
http://www.nhs.uk/Conditions/pregnancy-and-baby/Pages/episiotomy.aspx#How ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚