Perineorrhaphy

• What is Perineorrhaphy?

  Perineorrhaphy, also referred to as perineoplasty, is one of the fastest growing elective medical procedures and is the reparative or plastic surgery of the perineum which helps women with problems with vaginal opening laxity or looseness – medically referred to as “Vaginal Relaxation.” Many also incorrectly call this procedure “vaginoplasty” or “vaginaplasty.”

  Perineorrhaphy is the reconstruction of the muscles and tissues at the opening of the vagina and has successfully decreased the “introitus” or size of the vaginal opening. Perineorrhaphy does NOT reduce sexual sensation, in fact, properly performed, Perineorrhaphy INCREASES sensation for the woman as well as her husband/partner. Perineorrhaphy is the surgical repair of perineal lacerations and of vaginal opening looseness. It is a reconstruction of the muscles and tissues at the opening of the vagina. The procedure is very good at decreasing the size of the vaginal opening and does not reduce sensation.

• Results of Perineorrhaphy

  This is a procedure repairing the opening of the vagina which may be done under conditions where the woman complains of urinary incontinence, vaginal dryness, and unpleasurable intercourse or sexual dysfunction due to looseness of the perineum (stretching of the vaginal opening). Perineorrhaphy allows for the tightening of the vaginal opening and its surrounding structures.

  As a result of perineoplasty, the vaginal opening is tightened to its pre-pregnancy state, which not just increases pleasure during intercourse, but also rids patients of the other problems associated with a loose perineum.

• Candidates for Perineorrhaphy

  Perineorrhaphy is a surgical procedure done to address perineal body relaxation manifesting in women having wide and relaxed vaginal openings which may lead to weakness of the pelvic support structures or prolapse.
  Perineal lacerations and looseness may be experienced by women who:

  – Have had multiple child births
  – Experienced injury and strain during childbirth (long difficult labors in the pushing stage)
  – Gave birth to large babies
  – Have had inadequately or incompletely healed episiotomies performed at the time of childbirth
  – Are in their advanced age
  – Have hormonal inefficiencies
  – Are obese
  – Are engaged in strenuous physical activity

• The Perineorrhaphy Procedure

  A perineoplasty procedure first involves a V-shaped incision to the posterior wall of the vagina. Incisions atop the V-incision can be flat, curved, or angled upwards, which incision is applied is determined by the degree of vaginal tightening to be achieved. Once the incision is made, any existing scar tissue and abnormal tissue fixations that resulted from previous injury or surgery or injury are removed. The surgery Vaginoplasty is a surgical procedure that makes the vagina tighter by removing excess vaginal lining and tightening the surrounding soft tissues. Due to childbirth and even aging, the vagina can become stretched and the surrounding muscles lose their strength and tone. The loose feeling that many women feel is noticed even more by their male partner during sexual intercourse. Vaginoplasty decreases the diameter of the vagina, which results in increased friction during intercourse, making intercourse a much more pleasurable experience for the patient and her partner.

  Vaginoplasty, sometimes referred to as Vaginal Rejuvenation or Aesthetic Vaginal Surgery, can give your vagina a youthful appearance, give you more control of your vaginal muscles, and greatly increase the sexual satisfaction for you and your partner during intercourse.

  Labiaplasty
  – This surgery is for the removal of excess, floppy, or uneven labia minora (smaller interior vaginal lips) that often causes chronic irritation, rubbing, or discomfort during sexual intercourse. The term “Labiaplasty” can also relate to the cosmetic surgery of the labia majora (larger outer lips) to make it less prominent and floppy. Labiaplasty is most often done in the operating room but in selected cases surgery can be done in the office under local anesthetic at dramatically decreased costs. The Ellman Surgitron is also the tool of choice. This procedure takes 30 minutes to perform.

  Hymenoplasty
  – This surgery is the reconstruction of the hymen. Cultural, religious, or social reasons predominate when this surgery is contemplated. Hymenoplasty is performed to make the patient appear virginal. It only works for women who have not had vaginal deliveries, and preferably, in those who have never been pregnant. We take advantage of the Ellman Surgitron to make extremely precise incisions into the vagina and remnants of the hymeneal ring to bring them into close approximation to allow delicate sutures to hold the tissues in place. Once healed, the act of sexual intercourse can result in bleeding when the hymen is torn or stretched. This procedure takes 15 to 30 minutes to perform.

• Risk

  Like any cosmetic surgery, a perineoplasty involves the risk of infection or unnaturally heavy bleeding, although chances are minimal and they can be easily remedied with treatment.

• Recovery

  Patients undergoing Perineoplasty will have to abstain from sexual intercourse and heavy physical activity for a month to six weeks. One can return to work within a week of the operation.

FAQs

• Can my Perineum be restored to normal?
  - Yes, It can
• What does the surgery involve?
  - The vaginal opening is cut and the underlying tissues stitched back together using dissolvable stitches. The stitches remain in place for up to 6 weeks. A general anaesthetic will be given.
• How long does the surgery take?
  - The procedure can take just 30 to 45 minutes
• What will happen in the recovery period?
  - You should avoid sexual activity and physical exertion (especially carrying heavy things) for about a month. You may be able to return to work a week after your surgery. Your surgeon will discuss with you all possible complications and limitations of the operation before it is carried out.
• What is the recovery time?
  - You can expect to be fully recovered in 6 weeks.