Episiotomy not healed 3.5 months PP - perineal infection

[Lala1962]

Hi. Sorry I know it’s more post-natal but posting here as more traffic in the pregnancy topic!

I’m 3.5 months PP after giving birth in June and still not healed. I’m currently on my third round of antibiotics, this time for 10 days, as keep getting a perineal infection. My GP told me today she’s really sad for me as it’s really unusual for it to be going on this long. Whilst nice to get the sympathy it doesn’t really help knowing they don’t really know what to do next of these antibiotics still don’t work. I saw the gynae for my last infection as GP referred me to them and had a 7 day course of antibiotics.

It does improve with each course but still no less painful (stinging - ouch!) when it does flare up. I’m really hoping that this final course does the trick and gets it healing but I’ve had such a rubbish recovery from this childbirth overall and so many problems that I’m not too hopeful. I’m somewhat traumatised from the whole experience to be honest. Fortunately the GP and gynae don’t seem to see anything requiring cauterisation because having read stories about silver nitrate and the associated pain I’m scared to death of it.

Has anyone else had a similar experience? Any tips to help healing without further intervention?

I’m so ready for this all to be resolved. I’m sick of the pain, sick of having to get my bits out and prodded and poked and sick of never ending problems.

Seems very odd

Is it safe to assume you are not sexually active?

By this point I’d think you might need re-stitching or un stitching if you are sexually active

Definitely not sexually active.. nothing is going on down in that region until all healed!

It’s all joined up and has never come apart so doesn’t need stitches again but different areas are just not healed fully so the skin keeps getting infected. GP also thought it was strange as I’d never had an issue with the stitches, it just seems to be stuck at a certain level of healing and then gets infected.

Is it getting infected at the same bit?

I had an issue with mine and it took me way too long to realise that a seam on my comfy pants was rubbing. When it was really sore I'd go pantless mostly to let it air, it would heal and then I'd go back to pants and we'd start over again.

None of the people involved in my care (it went on for months) thought about clothing.

That’s a good point.. when there’s an issue I can often tell as the seam of my pants catches it and it stings so perhaps it’s rubbing without me realising. Each time it’s always the same bit that starts the infection (the external bit which touches my pants) and then spreads down a little bit to another point which is also slowly healing but presumably still prone to infection if the bacteria are there.

I was planning on letting it air as much as possible this time so maybe that will help!

How did yours eventually heal?

Do you think there might be a stitch left in?

Good point porridge!!!

Don’t know if this will make you feel any better but I had to have a toe cauterized with silver nitrate (kept getting infected) and don’t remember it hurting at all. So sorry you’re going through this, hope you recover soon x

@Lala1962 re the stinging, keep a washing up basin next to the loo, fill it with enough warm water and wee into that, rather than directly down the toilet.

It dilutes the urea.

It hasn’t been raised but the gynae did a very thorough examination and didn’t see anything. If I have to go back again though I’ll raise it as a possibility - thanks!

Fortunately I’ve still got my peri bottle so have been using that. It’s more the dabbing dry that stings when it flares up so just letting it air dry at the moment.

Thanks very much @MotiRoller - I hope so too!
Apparently silver nitrate hurts like hell on a perineal wound because it’s a sensitive area. The gynae said to me ‘thankfully it doesn’t look like anything needs to be cauterised because that’s very unpleasant’ then explained the process. I did some research on people having it for tissue granulation after episiotomies and the general consensus was that it sucked 🙁

That’s a good point.. when there’s an issue I can often tell as the seam of my pants catches it and it stings so perhaps it’s rubbing without me realising. Each time it’s always the same bit that starts the infection (the external bit which touches my pants) and then spreads down a little bit to another point which is also slowly healing but presumably still prone to infection if the bacteria are there.
* I was planning on letting it air as much as possible this time so maybe that will help!*

How did yours eventually heal?

That sounds very similar.

I had two weeks at home where I wore no underwear and skirts/dresses. Then I wore seamless shorts under skirts and dresses for 2 months (looked a treat in a skirt and boots with no tights on a very foul day!). Seemed to heal up enough to stop getting infected.

I still wear seamless underwear now several years later and I try and make sure I'm not wearing trousers or jeans that rub out of pure fear of it starting again.

Can you try boxer shorts instead of pants? They don't usually have a seam in that region, Wirapa do ladies boxers in cotton, you can get them on Amazon & are cotton so breathable & won't make you sweat.

My username, sadly, relates to my experience. Please don’t read on if my story is likely to frighten you.

In my case (forceps delivery) the incision was made between instead of across the muscle. The muscles went into spasm, holding the wound apart.

After 3 years I was offered Botox to stop the spasm. I was allowed that 3 times (3 years). It didn’t fully resolve things and I couldn’t climb a longer than average flight of stairs without the thing splitting again. It was extremely debilitating.

I asked about revision surgery but they refused, saying that too much scar tissue which would leave me too tight, and this would then become excruciating in menopause. There was, apparently, nothing they could do.

3 years later I slipped getting out of the bath and split it badly. Ended up in A+E, with a 4 hour wait to be seen. They offered me surgical repair, but I had to decide within 5 mins as so much time had elapsed and they were worried about the tissue being able to knit back together. Or I could leave it and see my GP the next day. I asked for a second opinion, and they rang the on call Gynae. I said I wasn’t taking that given the medic hadn’t actually assessed me. Scared and alone (DH was away) I went home with two lots of high strength antibiotics . GP reassured me that I had done the right thing, as this should now allow a new “bridge” of skin to form, which is exactly what happened.

I had years of counselling for the PTSD which cost thousands. It robbed me of my sex life and nearly my marriage, the chance to have more children, and was an incredibly lonely experience. Lots of waiting for appts with (male) consultants who basically shrugged their shoulders at my struggles. And when I went to discuss a complaint, it was clear they would protect the medic at all costs. Women’s healthcare in this country is beyond a joke.

I would suggest your underwear be men's boxer shorts. Make sure whatever cleansing product you are using in that area it's not irritating the open areas.

I had my episiotomy scar cauterised after over granulation of the scar tissue and I didn't feel a thing so please don't be worried about it. It felt much better afterwards

I know the constant fear feeling and it’s only been a few months!

I’ll pick up some seamless shorts I think and see how that helps. Thanks for your really helpful advice. Really sorry you went through this too but helpful to know it’s not just me at what could help.

Yes I think boxers/shorts would definitely be better as otherwise the seam sits right on the bit that starts the infection. Thank you for the suggestion!

I’m so sorry that happened to you, sounds like a horrendous experience 🙁 I hope things have been better since but it should never have happened it the first place!

Good idea too - they’re a bit more ‘flappy’ I think so would let air circulate. I haven’t used anything other than water down there since I gave birth. Partly why this is so frustrating as I’ve done everything ‘right’ but will just amp it up a bit.

Thanks for this, everything I’ve read says it’s horrible but I suppose most people don’t post about it if it goes fine. Not sure why the gynae commented as she did but perhaps she was just referring to me having another procedure as she could see how distressed I was about it all and just didn’t want to have to be there.

So sorry you're going through this. I also had multiple infections PP in my episiotomy and tear, but had started to come out the other side by 10w, so to still be struggling at nearly 13w PP is awful for you. I second the other posters who said air out as much as possible. Have they given you some good painkillers? I was on codeine and naproxen (as well as the antibiotics) because I was in so much pain I was struggling to function/care for DS. I also had a donut cushion I took everywhere for a while to sit on - pub, coffee shop, car etc, to try and keep the pressure off.

I also found they would do a swab and tell me results would take 10 days, but here's a 7 days course of antibs. I would finish them, and days later get a text saying yep you have an infection. I was just like what is the point of this system?! I've already finished the meds.

Really hope it gets better for you soon, it's so miserable!

sorry just seen it's 3.5m - closer to 16w! I really feel for you😣

Thanks Reabies and sorry to hear you went through it too! It is a rubbish system.

Fortunately as the episiotomy itself is all closed up I’m not actually in a lot of pain day to day, it’s the stinging when the skin infection at the incision site flares up that hurts but only when it catches on something or I go for a wee. I only ever had paracetamol/ibuprofen during the initial healing process as EBF so couldn’t have stronger but the infections didn’t really start until about 7/8 weeks in, about the time of my 6 week check. That makes me think that it could be where my pants are rubbing the skin as PPs have suggested, preventing it from fully healing on the outside. The gynae doesn’t think there has been an abscess or anything which is good at least.

Glad everything got sorted for you. Hopefully mine will be soon too.