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

[Dualta]

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

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.

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" . ELCS has been advised for dc2 though.

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?

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

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 .
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.