Painful granuloma from episiotomy

[Calimum33]

Hoping someone can relate!
I’m 14 weeks pp and dealing with a very painful granuloma from my episiotomy. It hurts to sit, wash and even walk! Backstory is; at 2 weeks pp I tore a stitch and the doctors claim my body “over healed” from that causing the granuloma. I am on the waitlist for an appointment to see the pelvic floor department at the hospital, however the wait for an appointment is minimum 6 months I’ve been told! (Not to mention the additional wait for any treatment following that!!) I paid an extraordinary amount of money to see a private Gynaecologist yesterday out of desperation. He told me that I wouldn’t be able to remove it using the typical silver nitrate route as it’s too large and due to the fact there are nerve endings in it, he says the granuloma will need to be removed under general anaesthetic and re stitched (At a 4 figure sum) : ( and said he can’t guarantee it won’t happen all over again! I’m hoping anyone can relate to my story or have advice on how their journey went with fixing their granuloma. Has anyone had it surgically removed? Did you deal with discharge as well due to the granuloma? So many questions!!!! Please help!!

From an old post in 2010 I think I've found a few solutions for you to look into.

One says: propolis gel from QVC
Another says: aromatherapist adv me to massage the scare tissue very firmly with extra virgin olive oil

Not sure how to link to the post but the title is: anyone have granulated scar tissue following tear in childbirth?

Hope it helps!

I’ve just seen this and know you made the post a couple of weeks ago but I also had a granuloma form on an episiotomy wound - very painful, lots of bleeding etc. Had it removed surgically but just with a local anaesthetic (was given the option of local or general but opted for local). Was told that if it was unsuccessful then it would be a Fentons procedure, but it was all fine. Felt almost totally better within a couple of days and no problems since!

Thank you for your response. I was offered general or spinal anaesthesia to surgically remove the granuloma .... very concerning as I would certainly choose local if given that choice. However, how was the healing process with the stitches? Was it comparable to the episiotomy healing?

No not at all, I was very worried about the healing as I was in agony for weeks with the episiotomy, but I barely felt anything and within a couple of days was totally fine, I think the swelling from the birth makes it a lot worse. If I recall correctly I was told not to bath or shower for 24 hours or so, and not to swim for a while I think but that was it! The doctor did lean towards general but as I wasn’t keen just did local and it was totally fine. Although having read your initial post again I am wondering if your doctor is suggesting a Fentons procedure?

Well your story gives me hope! I'm so glad you had such fantastic results. I don't believe it's a Fentons procedure as he didn't mention the term. I also have a very obvious large and painful granuloma that is visible. He said that would need to be removed as well as a small amount of skin on either side of it. He wants to avoid local as it's so painful and he doesn't believe I will be able to stand the discomfort of how wide he will need to open the vagina to be able to properly do the procedure. Sounds dreadful! He mentioned it shouldn't be nearly as painful after as there will only be a few stitches inside versus all of the external stitches with the episiotomy. Your statement about the site being so swollen following birth which may have made it more painful sounds like a very likely outcome. Do you know why they had to surgically remove yours as opposed to silver nitrate?

Oh, well I would imagine the consultant would have weighed up the risks and benefits of a general anaesthetic, but I would personally have pointed out to him that I had managed to stand pushing a baby out of it fairly recently which involved being quite stretched too (!!). It may well have been a different situation for me, but honestly it wasn’t particularly unpleasant at all (not exactly fun of course, but don’t remember it being very painful or anything). I think he recommended the surgical option as it was a large granuloma and various other treatments had not helped at that point.

@Calimum33 thanks for your post.
I was about to create the same thread, mine is exactly your story, scar tissue with granulation and may require surgical procedure to remove it , thank god my doctor has not mentioned any Fenton’s procedure , I am not sure if it’s the same :(
Can you please let me know, how did yours go ?

@DarlingBabyMom I’m sorry to hear you’re experiencing similar issues. I actually ended up getting a second opinion at a gynaecologist in America when I was home visiting a few months ago. He was shocked that I was considering surgery to remove the granulomas and insisted that using silver nitrate would sort me right out. I was reluctant as the fancy private Gynae in London insisted silver nitrate wouldn’t be appropriate as the granulomas were too large. However, I took the plunge and went with the silver nitrate and I am SO glad I did. It took three appointments of application of the nitrate (applying the silver nitrate is very quick and relatively painless, but the recovery is rather uncomfortable). But I am pleased to say it’s completely healed and 100% sorted the issue. I just can’t believe I almost went with surgery when the silver nitrate was so successful. Moral of the story get a second opinion!!!!!

@Calimum33 hey thanks for the reply. I totally agree of second opinion.
My Gynaecologist said the surgery because
I have the granulation not only outside but inside too and more worried about inside granulation (it’s kind of small lump) and for outer granulation said it will go on its own , no need to do anything.
Have you had extra tissue inside too ? Sorry for asking.

@DarlingBabyMom I did not have any internal granulation, however I do know they can use silver nitrate internally. It’s common practice on the cervix for example for various issues.