second degree perinal tear PLEASE HELP

[Jayj87]

I had my lb back in June, i had a normal vaginal delivery but tore inside into the perinal muscle. The midwife didn't clean me up to see the extent of the tear and i was told it was a first degree tear. I didn't feel right and knew the area felt like it was gaping. I went back and saw the same midwife who again said it was healing fine and i just needed to focus on my pelvic floor exercises. I still wasn't right at my 6week check and the doctor told me it was a second degree tear as i had tore the muscle inside. Ive been to see the gynecologist who has said i either have an op which poses risks due to scar tissue etc or i leave it. Im feeling lower than low and i don't know anyone in my position or know anyone who has been left with a second degree perineum tear. PLEASE HELP

This really matters and you do not need to put up with it.

1-2 degree tears aren't that "big" a deal, as long as they heal well and you are happy with the result. The muscles usually function perfectly well with a small tear - think of it as any other muscle, how many athletes get hamstring tears but go on to win championships? Scarring isn't necessarily a problem unless there is sensitivity there, and, even that can be treated.

3-4 degree tears are trickier to repair, but the outcome measure is the same - happiness with the result is what counts.

It's recent history, so, I wonder why the gynae mentioned scarring - do you have problems with poor healing? I wonder whether that is just standard pro + con chat, some women DO have problems with sensitivity on scar tissue. Can be treated, but it takes a bit of effort on the woman's part.

Get a referral to a pelvic physio (that's what I am) who'll be able to show you how to do pelvic floor exercises properly, and reassure you. I've seen hundreds of fannies and ones with missed second degree tears do just fine.

The important thing is that you are happy with it.

Congrats on the baby, too.

Thanks for your reply. Im not happy and haven't had any intimacy with my husband because of it. When i look down there i can see the torn muscle inside and the gyne has told me the layer between my bum and vagina is thin. When he discussed surgery he just made me aware that there could be complications after like there is any op. I just feel awful and just need to be back to as normal as possible. I left hospital yesterday and just cried, i wouldn't be in this situation if i had been stitched in the first place. I hope someone on here can share me their experience of having surgery in a similar scenario

So, what would "normal" be? Is it because your bits are different aesthetically? Or, are they not working as well as previously - so, are you leaking urine or poo, do you have pain or does it feel weak?

Missed tears aren't that common. There is a thread on here somewhere for "raggedies", folk with prolapses and tears. You might find some folk who have had repairs done on there.

I had a repair and tape put in and am all good down there now.

Op wasn't that awful, recovery was about 8 weeks but worth it.

I had a section with DC3 as they said I couldn't have gone through normal birth again but it was preferable IMO vaginal birth for me anyway.

My tear was missed too but it really isn't the end of the world although it feels like it at the time.

So you had a second degree tear? You haven't had any issues since the op? I know its not the end of the world but i can't stop crying about it at the moment, its getting me down massively. I asked the gynecologist what would happen if i decided to have more children (which i don't plan to) and he said id have to be cut but surely id tear straight through to my bum. Its nice to hear a successful op story uve made me feel a little better - thank you!

I had a muscle tear into the perineum but no skin tear - they just put a big stitch through it, which failed. No one said anything and all said it had healed fine etc and I had many smears etc. It was gapey, and I went off swimming as half the contents of the pool used to drain out when I got out.

I was not happy with it and had it repaired 20 years later. It was very hurty and took longer to recover from than I expected, but well worth it. I now have a perineum, my rectovaginal facia is not attached to it and everything feels more secure. I have not tried swimming though - I have really gone off the idea.

rectovagainal facia now attached, not not!

I don't want to upset you OP but just wanted to give my opinion. I had a second degree tear which was repaired immediately after the birth but I developed excess scar tissue and had to have surgery to 'refashion' my vaginal opening. Since then the scar tissue has returned and is far worse, meaning I'll need it done again but I'm too frightened. Recovering from the surgery was far worse than recovering from the birth, it took longer, wound got infected and it was extremely painful.

I think this may be what the gynae was referring to in terms of 'risk' and I'd urge you to consider avoiding surgery if it's an option. If the gynae has said you can manage without I'd seriously consider doing so. Many (perhaps most) women have no problems with recovery after vaginal surgery but having experienced it myself I wanted to warn you what you might be up against - I'm sure this is the 'risk' that has been mentioned.

Wishing you strength, I know it's awful to have any problems in that area and the midwife who dealt with you initially has let you down badly.

Remember OP that surgeons do surgery, which means that's their sea of expertise. That's fabulous when you really need surgery. In your case it sounds like it's an option, but not a necessity. Why not try getting a referral to a pelvic floor/woman's health physio as Stealth suggested, because their speciality is helping people make the most of what they have. They are trained to know when it's time to go for the op too, so you wouldn't lose anything by trying that route (they'll tell you pretty early on, if not straight away, if they can't help).

The whole thing sounds so upsetting because if someone had just taken the time to check, then you might be in a different and better situation. It's a bit of a "what if" situation and they only torture us. From what's been said - and you could also talk to the physio about it - it's not uncommon.

though OP because feeling like your body isn't yours, or isn't "right" is a horrible feeling.

Oh gosh completely mixed reviews. The only time i realise i have a problem is when i have a period it feels very uncomfortable or if ive opened my legs up to have a look. Sometimes it feels airy inside which makes me wonder how big the gape actually is. Ive got to go back mid December to see the same consultant so he has something to compare it to since he last looked so he can see if it looks any better. I feel completely let down by my midwife and i feel if she had done her job properly in the first place i may not be in this position. I don't have a lot of luck so i feel if i opted for surgery id be the percentage with complications. I may try the physio route to begin with

It is well worth working on the pelvic floor exercises before you go back to the consultant. (Gussie Grips used to write on here about them) It is always good to have good muscle tone, but no substitute for having the right bits stitched together.

I too felt let down :( They made a big fuss about my skin tear, which went all the way up to my clitoris and healed quickly, but did not bother about the muscles.

My tampons used to fall out too

The worst thing is 2weeks after my LB was born my midwife on a home visit took a look and said it could do with stitching, i went to hospital the following day and unfortunately saw the same midwife who delivered him she told me i was 'gaping' but never mentioned the torn muscle so twice she chose to ignore it. So my period has arrived today and i feel awful down there, i don't think i can deal with this forever. I need to feel normal again

Jay - I put up with it for over 20 years because I did not know any different and there was not the internet to find out about things. It was not a disaster, but I was never happy about it and am glad I did it. I was told the downsides in my case were that it would probably not do what I wanted (improve pooing, which it didn't) and that it would not improve my sex life (which it did sort of because I am happier) and I should do it to improve my self esteem . If you feel bad, then do the pelvic floor and tell the gynae you want it done (there are urogynaecologists now who deal with structural stuff).

If you are having tape put in to lift your bladder and things like that, these are more complicated and sometimes do not solve problems.

If it is a straight forward repair, then probably you risk it not quite meeting your expectations, which is not a disaster.

Have a look at the Raggedy Bits thread on General Health - there is a wealth of experience.