Perineal refashioning - wound not healed - would you have it done in this instance?

(6 Posts)
Dualta Mon 13-May-13 14:56:46

Hi there
Just looking for advice on this - had my dc2 11 weeks ago and had a very fast delivery (under 2 hrs but with a 30 minute pushing stage). I had a second degree tear but as the midwife was suturing this she noticed a large haematoma developing in the vaginal wall for which I was immediately transferred to surgery for draining (2 litres blood loss) and a surgical restitch.

The bruising and swelling was extensive and later the stitches became infected, now almost 3 months on the perineam has healed, however it has healed apart at the top 2cm of the perineum leaving a large gap to one side. there also appears to be a mess of scar tissue to once side on the vaginal wall where the haematoma was drained.

This is the second time I;ve had a tear and stitches and I seem to have only half my perineum left.

I'm really upset about this - especially after the trauma of the surgery (lost litres of blood and couldn't get up for three weeks etc) I know its not as though anyone else would notice it or care, but I do, I hate the thought of being disfigured somehow.

The surgeon checked it at 6 weeks and said that the stitches had come apart due to infection and there was no choice but to wait for it to heal naturally itself, and I have a gynae appoinment in 3 weeks.

Would a perineal repair restore the area if it has healed in this way? Has anyone experienced this? Do I have to 'make a case' for having it repaired?

I want to have more children but will be pushing for elcs for any future births after the shock of the last two deliveries

Any advice at all would be super - ps I have also had a look at the raggedy bits threads but i felt maybe this wasn't as serious a case so wasnt sure to post there

Thanks so much everyone

cravingcake Mon 13-May-13 15:41:10

You are welcome to come join the Ragged Bits thread, all cases where your bits are not what they were are welcome for moral support. There are a few on there that would really be able to offer advice so try reposting there as well.

I've been offered a refashion but haven't had the surgery as its not the right time for me, we want another baby and I have other prolapse issues going on. I had a 4th degree tear but from what you have said it sounds like you should be offered a refashion, or some sort of correcting/fixing as its affecting your life and no-one should have to put up with it.

Coffee1Sugar Mon 13-May-13 17:47:07

I had a refashion 3months postnatal following a 3a tear which was insufficiently stitched. I went private as I was too traumatised by the nhs hospital I had dd at. Definitely recommend going for the procedure. Yes recovery was sore for a couple of weeks but I'm a million times better now. The surgeon even fixed a minor rectocele I didn't even know about and many a GP have commented on my "designer vagina" grin. ELCS has been advised for dc2 though.

Dualta Tue 14-May-13 21:19:19

Hello to both of you and thank you so much for your replies! Definitely want to get this done if it is as you say Coffee - can I just ask - how do they restitch if it has healed apart?

Coffee1Sugar Wed 15-May-13 11:24:36

Theyll completely undo all the stitches/scar tissue and restitch. Definitely recommend it!

thing1andthing2 Fri 17-May-13 20:26:29

I had a minor op on my perineum after dc2 to address a slight prolapse and a perineal ridge. The surgeon termed my prolapse as a "deficient perineum" - nice. He promised he would fix the prolapse and leave me a nice smooth perineum which would stop being uncomfortable.
To be honest, I haven't had a great experience. The op was not great as I had it under a local with no sedative due to breastfeeding, I wouldn't choose that again. It was very painful for about 5 days and then quickly improved but I have only just been able to start having sex again and the op was 6 months ago. I needed scar tissue cauterising and I have had to do lots of perineal massage and stretching as some bits were just pulled too tight in the stitch up. Also the prolapse is only about 80% fixed.
However, I may had just had a dodgy surgeon as he is no longer doing any clinics and no one will explain exactly why hmm.
If I had my time again I would have waited until my ds was older (he was 4 months at time of op), maybe till he was 2 or 3. I was advised to do as little lifting as possible and that's just not possible with a baby and a 2 year old and I wonder if I overdid it in the recovery period making the recovery longer. I would probably still go ahead with the op though. Even though it has been a long road and I was not entirely happy with the result, at least the prolapse is mostly fixed and I can just put it all behind me and move on.
I found it very easy to get offered the op, I got a referral to gynaecology from my gp and saw this surgeon and he put me on his list right away. You need to see a Uro-gynaecologist I think, someone who specialises in pelvic floors.
Good luck.

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